Provider Demographics
NPI:1619187267
Name:COUNTY OF SAWYER
Entity Type:Organization
Organization Name:COUNTY OF SAWYER
Other - Org Name:SAWYER COUNTY AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NATE
Authorized Official - Middle Name:R
Authorized Official - Last Name:DUNSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-638-3458
Mailing Address - Street 1:10676 NYMAN AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:WI
Mailing Address - Zip Code:54843-6554
Mailing Address - Country:US
Mailing Address - Phone:715-638-3458
Mailing Address - Fax:
Practice Address - Street 1:10676 NYMAN AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:WI
Practice Address - Zip Code:54843
Practice Address - Country:US
Practice Address - Phone:715-634-4788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60000954341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41333500Medicaid
WI000084239Medicare PIN