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BLOOMFIELD GENOA CITY FIRE & RESCUE
NPI 1558444828
Ambulance - Land Transport in Pell Lake, WI

Active since October 23, 2006CLIA 52D0986047 · Waiver
N 1113 CLOVER RD., PELL LAKE, WI 53157(262) 279-2033 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Bloomfield Genoa City Fire & Rescue NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLOOMFIELD GENOA CITY FIRE & RESCUE (NPI 1558444828) is a healthcare organization registered as a land transport in Pell Lake, Wisconsin and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through May 6, 2027 and lists Brad Poltermann, Fire Chief, as its authorized official.

NPPES Registry Identity

NPI1558444828
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameBLOOMFIELD GENOA CITY FIRE & RESCUE
Location AddressN 1113 CLOVER RD.Pell Lake, WI 53157
Mailing Address395 W Lake StElmhurst, IL 60126-1508 · (630) 530-2988 · Fax (630) 903-2830
Phone(262) 279-2033
Organization SubpartNo
Authorized OfficialBrad PoltermannFire Chief · (262) 279-2033
Enumeration DateOctober 23, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1558444828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
License✔ Licensed in WI · 6001223
N 1113 CLOVER RD., Pell Lake, WI 53157
Open in Google Maps ↗

Other Identifiers 2

Medicaid396005800001WI
Other39600580018WI · Bcbs

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 52D0986047

Bloomfield Genoa City Fire & Rescue · Pell Lake, WI
Active · expires May 6, 2027
CLIA Number52D0986047
Laboratory TypeAmbulance
Certificate Effective DateMay 7, 2025
Certificate Expiration DateMay 6, 2027
Laboratory DirectorMr. Fredric J. Schalow
Laboratory Phone(262) 279-2033
Laboratory LocationBloomfield Genoa City Fire & RescueN1113 Clover Rd, Pell Lake, WI 53157
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
1,738 services70 patients
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.
60 services43 patients
Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427
Ambulance Service, Advanced Life Support, Level 1 (ALS 1 - Emergency) is a critical care transport service for emergency situations. It includes a team of healthcare professionals equipped with advanced skills and tools to manage life-threatening conditions during transport.
56 services39 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bloomfield Genoa City Fire & Rescue's NPI number?

The NPI number for Bloomfield Genoa City Fire & Rescue is 1558444828. It was assigned to this organization in the NPPES registry on October 23, 2006.

Where is Bloomfield Genoa City Fire & Rescue located?

Bloomfield Genoa City Fire & Rescue is located at N 1113 Clover Rd., Pell Lake, WI 53157. The listed phone number is (262) 279-2033.

What is Bloomfield Genoa City Fire & Rescue's specialty?

The primary specialty registered for this NPI is Ambulance, specializing in Land Transport, with taxonomy code 3416L0300X.

Does Bloomfield Genoa City Fire & Rescue hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 52D0986047) is associated with this NPI, valid through May 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Bloomfield Genoa City Fire & Rescue was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.