Provider Demographics
NPI:1841293768
Name:COUNTY OF LINCOLN
Entity type:Organization
Organization Name:COUNTY OF LINCOLN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAUCHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-539-1019
Mailing Address - Street 1:801 N SALES ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-1633
Mailing Address - Country:US
Mailing Address - Phone:715-536-1019
Mailing Address - Fax:715-539-8054
Practice Address - Street 1:801 N SALES ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MERRILL
Practice Address - State:WI
Practice Address - Zip Code:54452-1633
Practice Address - Country:US
Practice Address - Phone:715-539-1019
Practice Address - Fax:715-539-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60201213416L0300X
WI60001213416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41329500Medicaid
WI41329500Medicaid