Village of Big Bend
Organization Active NPI Land Ambulance · Big Bend, WI
NPI 1003840604 · NPPES record last updated Oct 2, 2023
Key facts
- NPI
- 1003840604
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- License
- 67360 (WI)
- Legal business name
- VILLAGE OF BIG BEND
- Practice address
- W230S9185 Nevins St
Big Bend, WI 53103-9722 - Phone
- (262) 662-2747
- Fax
- (262) 662-3751
- NPI assigned
- Jul 10, 2006
- Organization subpart
- No
Authorized official
- Name
- James Soneberg
- Title
- Assistant Chief
- Phone
- (262) 662-2747
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110518000456 | WI | Part B Supplier - Ambulance Service Supplier | 2163608670 | Practice locations: Big Bend, WI |
National Provider Directory
Locations
W230S9185 Nevins St
Big Bend, WI 53103
Phone (262) 408-8746
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 67360 | WI | Yes |
Addresses
Primary practice location
W230S9185 Nevins St
Big Bend, WI 53103-9722
Mailing address
W230S9185 Nevins St
Big Bend, WI 53103-9722
Phone (262) 662-2747
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41358000 | Medicaid | WI |
Other names
- Big Bend Fire Department
Other providers in Big Bend, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.