Stone Bank Volunteer Fire

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

6001211 Issued in WI

Legal business name

STONE BANK VOLUNTEER FIRE

Practice address

W335N7107 Stonebank Rd
Oconomowoc, WI 53066-1407

Phone

(262) 966-2414

Fax

(262) 966-2831

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Mark G Klokow

Title

Chief

Phone

(262) 966-2414

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1780632497",
    "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",
            "fax_number": "262-375-9608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "W335N7107 STONEBANK RD",
            "city": "OCONOMOWOC",
            "state": "WI",
            "postal_code": "530661407",
            "telephone_number": "262-966-2414",
            "fax_number": "262-966-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STONE BANK VOLUNTEER FIRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "KLOKOW",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "262-966-2414"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "WI",
            "license": "6001211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41359600",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Christopher J Stoeckl, DDS
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• Amanda Struck, LPC
• Skyler Stubblefield, PHARMD
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• Land Ambulance in Oconomowoc, WI
• Providers in Oconomowoc, WI by specialty
• Land Ambulance in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.