Provider Demographics
NPI:1427106699
Name:CITY OF RACINE
Entity type:Organization
Organization Name:CITY OF RACINE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-635-7900
Mailing Address - Street 1:810 8TH ST
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1433
Mailing Address - Country:US
Mailing Address - Phone:262-635-7911
Mailing Address - Fax:262-635-7864
Practice Address - Street 1:810 8TH ST
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1433
Practice Address - Country:US
Practice Address - Phone:262-635-7900
Practice Address - Fax:262-635-7864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-06
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60001943416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41345100Medicaid
WI590013644OtherMEDICARE RAILROAD
WI41345100Medicaid
WI41345100Medicaid