VILLAGE OF JACKSON NPI 1770686610

NPI Information

NPI: 1770686610
Provider Name: VILLAGE OF JACKSON

Doing Business As: JACKSON FIRE DEPARTMENT

Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

Address:
W204N16722 JACKSON DR
JACKSON, WI
ZIP 53037
Phone: (262) 677-3811
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VILLAGE OF JACKSON is a land transport ambulance in Jackson, WI. VILLAGE OF JACKSON NPI is 1770686610. The provider is registered as an organization entity type.
The provider Is Doing Business As Jackson Fire Department.

The provider's business location address is:

W204N16722 JACKSON DR
JACKSON, WI
ZIP 53037-796
Phone: (262) 677-3811
Fax: (262) 677-9471

The provider's authorized official is John Michael Skodinski .
The authorized official title is Fire Chief and has the following contact phone number (262) 677-3811.

The CLIA number assigned to this NPI record is 52D0987553 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/6/2006 and was last updated on 12/15/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000081077	MEDICARE ID-TYPE UNSPECIFIED	WISCONSIN	MEDICARE GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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