Provider Demographics
NPI:1508860982
Name:CITY OF KAUKAUNA
Entity Type:Organization
Organization Name:CITY OF KAUKAUNA
Other - Org Name:KAUKAUNA RESCUE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:HIRTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-766-6320
Mailing Address - Street 1:201 W. SECOND STREET
Mailing Address - Street 2:PO BOX 890
Mailing Address - City:KAUKAUNA
Mailing Address - State:WI
Mailing Address - Zip Code:54130-0890
Mailing Address - Country:US
Mailing Address - Phone:920-766-6312
Mailing Address - Fax:920-766-6339
Practice Address - Street 1:201 W. SECOND STREET
Practice Address - Street 2:
Practice Address - City:KAUKAUNA
Practice Address - State:WI
Practice Address - Zip Code:54130-0890
Practice Address - Country:US
Practice Address - Phone:920-766-6312
Practice Address - Fax:920-766-6339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60007133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41324400Medicaid