Provider Demographics
NPI:1770537474
Name:MOSINEE FIRE DISTRICT
Entity type:Organization
Organization Name:MOSINEE FIRE DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-693-2059
Mailing Address - Street 1:PO BOX 202
Mailing Address - Street 2:
Mailing Address - City:MOSINEE
Mailing Address - State:WI
Mailing Address - Zip Code:54455-0202
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:303 3RD ST
Practice Address - Street 2:
Practice Address - City:MOSINEE
Practice Address - State:WI
Practice Address - Zip Code:54455-1424
Practice Address - Country:US
Practice Address - Phone:715-693-2059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41358300Medicaid
=========010OtherVALLEY HEALTH PLAN
WI41358300Medicaid
P00112232Medicare ID - Type UnspecifiedRAILROAD MEDICARE