Provider Demographics
NPI:1881639912
Name:PICKEREL VOLUNTEER FIRE DEPARTMENT AND RESCUE SQUAD INC
Entity type:Organization
Organization Name:PICKEREL VOLUNTEER FIRE DEPARTMENT AND RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TIPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-740-7040
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:PICKEREL
Mailing Address - State:WI
Mailing Address - Zip Code:54465-0010
Mailing Address - Country:US
Mailing Address - Phone:715-740-7040
Mailing Address - Fax:
Practice Address - Street 1:N9062 STATE ROAD 55
Practice Address - Street 2:
Practice Address - City:PICKEREL
Practice Address - State:WI
Practice Address - Zip Code:54465
Practice Address - Country:US
Practice Address - Phone:715-484-7700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60-010433416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41330500Medicaid
WI590004123OtherRAILROAD MEDICARE
WI41330500Medicaid