Organization
FOX LAKE COMMUNITY FIRE ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL KOTTKE (SECRETARY TREASURER)
(920) 960-7754
Entity
Organization
Contact information
Practice address
246 E STATE ST, FOX LAKE, WI 53933-8027
(920) 928-6115
Mailing address
W8542 LAUREL HILL RD, FOX LAKE, WI 53933-9739
(920) 928-6115
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
6000139
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41314800
H.I.R.S.P.
WI
05
—
41314800
—
WI
Enumeration date
05/30/2006
Last updated
06/09/2025
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