Provider Demographics
NPI:1942207402
Name:CITY OF ASHLAND
Entity Type:Organization
Organization Name:CITY OF ASHLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHENIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-682-7052
Mailing Address - Street 1:300 STUNTZ AVE
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:WI
Mailing Address - Zip Code:54806-1952
Mailing Address - Country:US
Mailing Address - Phone:715-682-7052
Mailing Address - Fax:715-682-7903
Practice Address - Street 1:300 STUNTZ AVE
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:WI
Practice Address - Zip Code:54806-1952
Practice Address - Country:US
Practice Address - Phone:715-682-7052
Practice Address - Fax:715-682-7903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-30
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60003493416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41329700Medicaid
590011198OtherRAILROAD MEDICARE
WI000083331Medicare ID - Type Unspecified