Provider Demographics
NPI:1184730442
Name:WAUBEKA FIRE DEPARTMENT
Entity type:Organization
Organization Name:WAUBEKA FIRE DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:CASWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:262-692-2656
Mailing Address - Street 1:W4114 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:WAUBEKA
Mailing Address - State:WI
Mailing Address - Zip Code:53021-9712
Mailing Address - Country:US
Mailing Address - Phone:262-692-2656
Mailing Address - Fax:262-692-2061
Practice Address - Street 1:W4114 RIVER RD
Practice Address - Street 2:
Practice Address - City:WAUBEKA
Practice Address - State:WI
Practice Address - Zip Code:53021-9712
Practice Address - Country:US
Practice Address - Phone:262-692-2656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI85195Medicare ID - Type Unspecified