Pittsville Vol Fire Dept Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

PITTSVILLE VOL FIRE DEPT INC

Doing business as

Pittsville Fire Dept Ambulance Service

Practice address

5388 4TH Ave
Pittsville, WI 54466-9342

Phone

(715) 884-6514

NPI assigned

May 13, 2006

Last updated

Oct 22, 2012By 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

Gerald Minor

Title

Chief

Phone

(715) 884-6514

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Pittsville Fire Dept Ambulance Service Doing business as

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1447201611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 241",
            "city": "PITTSVILLE",
            "state": "WI",
            "postal_code": "544660241",
            "telephone_number": "715-884-6514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5388 4TH AVE",
            "city": "PITTSVILLE",
            "state": "WI",
            "postal_code": "544669342",
            "telephone_number": "715-884-6514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PITTSVILLE VOL FIRE DEPT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "MINOR",
        "authorized_official_first_name": "GERALD",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "715-884-6514"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41341100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE",
            "identifier": "WI0101",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN'S PLUS",
            "identifier": "1012447",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVOCARE MC HMO",
            "identifier": "000088307",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2165155-00",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pittsville Fire Dept Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Land Ambulance in Pittsville, WI
• Providers in Pittsville, 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 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.