Provider Demographics
NPI:1285724690
Name:TOWN OF DELAVAN
Entity type:Organization
Organization Name:TOWN OF DELAVAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:ENDISCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-728-3471
Mailing Address - Street 1:5621 TOWN HALL RD
Mailing Address - Street 2:
Mailing Address - City:DELAVAN
Mailing Address - State:WI
Mailing Address - Zip Code:53115-3712
Mailing Address - Country:US
Mailing Address - Phone:262-728-2471
Mailing Address - Fax:262-728-3473
Practice Address - Street 1:5698 TOWN HALL RD
Practice Address - Street 2:
Practice Address - City:DELAVAN
Practice Address - State:WI
Practice Address - Zip Code:53115-3712
Practice Address - Country:US
Practice Address - Phone:262-728-3780
Practice Address - Fax:262-728-4022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6000934341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance