| Organization Name: | BLOOMFIELD GENOA CITY FIRE & RESCUE |
| NPI Number: | 1558444828 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRAD POLTERMANN (FIRE CHIEF) |
| Mailing Address: | N 1113 Clover Rd. Pell Lake |
| State: | WI US |
| Postal Code: | 53157 |
| Phone Number: | 2622792033 |
| Fax Number: | |
| NPI Enumeration Date: | 10/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 6001223 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |