Provider Demographics
NPI:1871582999
Name:BLACK RIVER FALLS FIRE DEPT
Entity type:Organization
Organization Name:BLACK RIVER FALLS FIRE DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JODY
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:STOKER
Authorized Official - Suffix:
Authorized Official - Credentials:AEMT
Authorized Official - Phone:715-284-2656
Mailing Address - Street 1:PO BOX 455
Mailing Address - Street 2:
Mailing Address - City:BLACK RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54615-0455
Mailing Address - Country:US
Mailing Address - Phone:715-284-2656
Mailing Address - Fax:715-284-4227
Practice Address - Street 1:30 S WATER ST
Practice Address - Street 2:
Practice Address - City:BLACK RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54615-1716
Practice Address - Country:US
Practice Address - Phone:715-284-2656
Practice Address - Fax:715-284-4227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60-008283416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport