Healthcare Provider Details

I. General information

NPI: 1831265644
Provider Name (Legal Business Name): BELMONT FIRE PROTECTION DISTRICT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 02/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 MARKET ST.
BELMONT WI
53510-0052
US

IV. Provider business mailing address

PO BOX 52
BELMONT WI
53510-0052
US

V. Phone/Fax

Practice location:
  • Phone: 608-762-5495
  • Fax: 608-762-5533
Mailing address:
  • Phone: 608-762-5495
  • Fax: 608-762-5533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number60-00400
License Number StateWI

VIII. Authorized Official

Name: ROBERTA J BUSS
Title or Position: BILLING CLERK
Credential:
Phone: 608-762-5495