Provider Demographics
NPI:1598896441
Name:CLINTON FIRE PROTECTION DISTRICT
Entity Type:Organization
Organization Name:CLINTON FIRE PROTECTION DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:SKOKUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-676-5550
Mailing Address - Street 1:PO BOX 153
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:WI
Mailing Address - Zip Code:53525-0153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:145 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:WI
Practice Address - Zip Code:53525-9052
Practice Address - Country:US
Practice Address - Phone:608-676-5550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41309600Medicaid