Provider Demographics
NPI:1902095169
Name:CITY OF SCHOFIELD
Entity Type:Organization
Organization Name:CITY OF SCHOFIELD
Other - Org Name:SCHOFIELD FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-359-3500
Mailing Address - Street 1:200 PARK ST
Mailing Address - Street 2:
Mailing Address - City:SCHOFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54476-1193
Mailing Address - Country:US
Mailing Address - Phone:715-359-5230
Mailing Address - Fax:715-359-5973
Practice Address - Street 1:20 ALEXANDER AVE
Practice Address - Street 2:
Practice Address - City:ROTHSCHILD
Practice Address - State:WI
Practice Address - Zip Code:54474-1739
Practice Address - Country:US
Practice Address - Phone:715-359-3500
Practice Address - Fax:715-359-7268
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF SCHOFIELD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-23
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6000505341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
52D0983380OtherCLIA
WI4132400Medicaid
WI4132400Medicaid
WI000082331Medicare PIN