Provider Demographics
NPI:1427648526
Name:LAFAYETTE COUNTY
Entity type:Organization
Organization Name:LAFAYETTE COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WIEGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-776-4466
Mailing Address - Street 1:800 CLAY ST
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:WI
Mailing Address - Zip Code:53530-1228
Mailing Address - Country:US
Mailing Address - Phone:160-877-6446
Mailing Address - Fax:
Practice Address - Street 1:129 W LOUISA ST
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:WI
Practice Address - Zip Code:53530-1419
Practice Address - Country:US
Practice Address - Phone:608-776-4466
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LAFAYETTE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport