Town of Plum Lake
Organization Active NPI Land Ambulance · Sayner, WI
NPI 1376590208 · NPPES record last updated Jan 28, 2026
Key facts
- NPI
- 1376590208
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- TOWN OF PLUM LAKE
- Practice address
- 2821 State Hwy 155
Sayner, WI 54560 - Phone
- (715) 358-1176
- NPI assigned
- May 27, 2006
- Organization subpart
- No
Authorized official
- Name
- Kevin Rasmussen
- Title
- Service Director
- Phone
- (715) 892-1877
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 52D0981844 | Plum Lake Ambulance | Certificate of waiver | Jan 8, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070122000179 | WI | Part B Supplier - Ambulance Service Supplier | 2860493624 | Practice locations: Sayner, WI |
National Provider Directory
Locations
2616 State Highway 155
Sayner, WI 54560
Phone (715) 542-3367
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
2821 State Hwy 155
Sayner, WI 54560
Mailing address
PO Box 7
Sayner, WI 54560-0007
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1028593 | Other | PHYSICIAN'S PLUS | |
| 000084834 | Other | ADVOCARE MCHMO | |
| 006235 | Other | HEALTH ALLIANCE | |
| 41309200 | Medicaid | WI | |
| WI0101 | Other | JOHN DEERE |
Other names
- Town of Plum Lake Ambulance
Other providers in Sayner, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 28, 2026. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.