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Fox Lake Community Fire Association

Fox Lake Community Fire Association is a health care provider in Fox Lake, WI. In this page you will find its mailing address, practice location, phone number, specialty etc.

physician-icon Basic Information

Practice Location 246 E State St, Fox Lake, WI 53933-8027, US
Practice Location Phone920-928-6115
Practice Location Fax
Legal Business NameFOX LAKE COMMUNITY FIRE ASSOCIATION
NPI ?1184671448
Entity TypeOrganization
Enumeration Date ? May 30, 2006
Last Update Date ? Jul 9, 2007
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Fox Lake Community Fire Association

SpecialtySpecializationLicenseLicense State
AmbulanceLand Transport 6000139Wisconsin

legacy-id-icon Legacy Provider IDs of Fox Lake Community Fire Association

Provider IdIssuer StateIssuer TypeIssuer
41314800WisconsinOtherWISCONSIN RENAL PROGRAM
41314800WisconsinOtherH.I.R.S.P.
41314800WisconsinMedicaid

official-icon Authorized Official of Fox Lake Community Fire Association

An authorized official is an appointed official with the legal authority to make changes and/or updates to the Fox Lake Community Fire Association's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).

Authorized Official Mr. Russell Kottke
Authorized Official Title/PositionSECRETARY TREASURER
Authorized Official Phone Number920-928-6115