Provider Demographics
NPI:1861610883
Name:STRATFORD AREA FIRE DEPARTMENT
Entity type:Organization
Organization Name:STRATFORD AREA FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COMMISSION CHAIRPERSON
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIESMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-897-4589
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:WI
Mailing Address - Zip Code:54484-0103
Mailing Address - Country:US
Mailing Address - Phone:715-387-3988
Mailing Address - Fax:715-387-0646
Practice Address - Street 1:212200 STATE HIGHWAY 97
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:WI
Practice Address - Zip Code:54484-4326
Practice Address - Country:US
Practice Address - Phone:715-687-4157
Practice Address - Fax:715-391-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60-3553416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA231652151AMedicaid
WI41343500Medicaid
WI=========OtherTRICARE ANTHEM ALLIANCE