Provider Demographics
NPI:1831265644
Name:BELMONT FIRE PROTECTION DISTRICT, INC.
Entity type:Organization
Organization Name:BELMONT FIRE PROTECTION DISTRICT, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:ROBERTA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BUSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-762-5495
Mailing Address - Street 1:PO BOX 52
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:WI
Mailing Address - Zip Code:53510-0052
Mailing Address - Country:US
Mailing Address - Phone:608-762-5495
Mailing Address - Fax:608-762-5533
Practice Address - Street 1:103 MARKET ST.
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:WI
Practice Address - Zip Code:53510-0052
Practice Address - Country:US
Practice Address - Phone:608-762-5495
Practice Address - Fax:608-762-5533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-27
Last Update Date:2019-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X, 3416L0300X
WI60-00400146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
No341600000XTransportation ServicesAmbulanceGroup - Single Specialty
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41331700Medicaid
WI000083855Medicare ID - Type Unspecified