Village of Campbellsport

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

VILLAGE OF CAMPBELLSPORT

Doing business as

Campbellsport Vol Fire Dept

Practice address

548 E Main St
Campbellsport, WI 53010

Phone

(920) 533-5266

NPI assigned

Aug 19, 2006

Last updated

Oct 10, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David SulikNPI 1760602072

Title

Billing Manager

Phone

(262) 375-9610

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CAMPBELLSPORT VOL FIRE DEPT Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Sulik, MANAGER

  • Land Ambulance
  • Footville, WI
  • NPI 1760602072
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1265546600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 72140",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530127340",
            "telephone_number": "262-375-9610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 E MAIN ST",
            "city": "CAMPBELLSPORT",
            "state": "WI",
            "postal_code": "53010",
            "telephone_number": "920-533-5266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE OF CAMPBELLSPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "SULIK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "262-375-9610",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41327600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAMPBELLSPORT VOL FIRE DEPT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Calyn Sue Strobel, RN
• Katherine Su, DDS
• Transtar Medical LTD.
• Dean William Uelmen, D.D.S.
• Village Apothecary Inc (The Village Apothecary)
• Lynn Wernicke, LPN
• Amanda Marie Wier, LPN
• Ashley M Zimdahl, RN

• Land Ambulance in Campbellsport, WI
• Providers in Campbellsport, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.