Provider Demographics
NPI:1346463684
Name:ARENA FIRE BOARD
Entity Type:Organization
Organization Name:ARENA FIRE BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE BOARD SEC TREAS
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:WILKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-753-2335
Mailing Address - Street 1:PO BOX 76
Mailing Address - Street 2:
Mailing Address - City:ARENA
Mailing Address - State:WI
Mailing Address - Zip Code:53503
Mailing Address - Country:US
Mailing Address - Phone:608-753-2335
Mailing Address - Fax:608-753-2335
Practice Address - Street 1:111 DAVID CIRCLE
Practice Address - Street 2:
Practice Address - City:ARENA
Practice Address - State:WI
Practice Address - Zip Code:53503
Practice Address - Country:US
Practice Address - Phone:608-753-2335
Practice Address - Fax:608-753-2335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41330800Medicaid