1841293768 NPI number — COUNTY OF LINCOLN

Table of content: (NPI 1841293768)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841293768 NPI number — COUNTY OF LINCOLN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COUNTY OF LINCOLN
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LINCOLN COUNTY EMS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841293768
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/11/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
801 N SALES ST
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
MERRILL
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54452-1633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-536-1019
Provider Business Mailing Address Fax Number:
715-539-8054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
801 N SALES ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MERRILL
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54452-1633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-539-1019
Provider Business Practice Location Address Fax Number:
715-539-8054
Provider Enumeration Date:
05/24/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RAUCHLE
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINISTRATIVE SECRETARY
Authorized Official Telephone Number:
715-539-1019

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  6020121 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 6000121 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 41329500 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com