| Organization Name: | FOX LAKE COMMUNITY FIRE ASSOCIATION |
| NPI Number: | 1184671448 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUSSELL KOTTKE (SECRETARY TREASURER) |
| Mailing Address: | 246 E State St Fox Lake |
| State: | WI US |
| Postal Code: | 539338027 |
| Phone Number: | 9209286115 |
| Fax Number: | |
| NPI Enumeration Date: | 05/30/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 6000139 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |