Provider Demographics
NPI:1467572891
Name:PEMBINE DUNBAR BEECHER RESCUE SQUAD
Entity Type:Organization
Organization Name:PEMBINE DUNBAR BEECHER RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMT/OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-324-5656
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:PEMBINE
Mailing Address - State:WI
Mailing Address - Zip Code:54156-0220
Mailing Address - Country:US
Mailing Address - Phone:715-324-5656
Mailing Address - Fax:715-923-8813
Practice Address - Street 1:N 18251 HWY 141
Practice Address - Street 2:
Practice Address - City:PEMBINE
Practice Address - State:WI
Practice Address - Zip Code:54156-0990
Practice Address - Country:US
Practice Address - Phone:715-324-5656
Practice Address - Fax:715-324-6474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41330200Medicaid
WI000083423Medicare ID - Type UnspecifiedAMBULANCE SERVICE