Long Lake-Tipler Rescue Squad LTD
Organization Active NPI Ambulance · Tipler, WI
NPI 1447446299 · NPPES record last updated Feb 9, 2018
Key facts
- NPI
- 1447446299
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- Legal business name
- LONG LAKE-TIPLER RESCUE SQUAD LTD
- Practice address
- 11098 Dream Lake Rd
Tipler, WI 54542 - Phone
- (715) 889-2674
- NPI assigned
- Sep 14, 2007
- Organization subpart
- No
Authorized official
- Name
- Lee Gorr
- Title
- President
- Phone
- (715) 889-4592
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | Yes |
Addresses
Primary practice location
11098 Dream Lake Rd
Tipler, WI 54542
Mailing address
PO Box 137
Long Lake, WI 54542-0137
Phone (715) 889-2674
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41314500 | Medicaid | WI |
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.