Provider Demographics
NPI:1447442413
Name:BROOKLYN FIRE & EMS PROTECTION DISTRICT
Entity type:Organization
Organization Name:BROOKLYN FIRE & EMS PROTECTION DISTRICT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTELT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-455-3812
Mailing Address - Street 1:PO BOX 248
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:WI
Mailing Address - Zip Code:53521-0248
Mailing Address - Country:US
Mailing Address - Phone:608-455-3812
Mailing Address - Fax:608-455-3813
Practice Address - Street 1:401 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:WI
Practice Address - Zip Code:53521
Practice Address - Country:US
Practice Address - Phone:608-455-3812
Practice Address - Fax:608-455-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41354500Medicaid
WI000086177Medicare UPIN