LAUDERDALE-LAGRANGE FIRE DEPARTMENT, INC.
NPI 1114924206
Ambulance - Land Transport in Whitewater, WI

NPI Status: Active since July 05, 2005

Contact Information

W6080 US HIGHWAY 12
WHITEWATER, WI
ZIP 53190
Phone: (262) 495-8400
Fax: (262) 495-8426

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  • Organization
  • Ambulance
  • Land Transport
  • CLIA Number: 52D0930734
  • CLIA Cert. Type: Ambulance
  • CLIA Exp. Date: 07-16-2025

About LAUDERDALE-LAGRANGE FIRE DEPARTMENT, INC.

This page provides the complete NPI Profile along with additional information for Lauderdale-lagrange Fire Department, Inc., a provider established in Whitewater, Wisconsin operating as a Ambulance, focusing in land transport . The healthcare provider is registered in the NPI registry with number 1114924206 assigned on July 2005. The practitioner's primary taxonomy code is 3416L0300X with license number 60-00522 (WI). The provider is registered as an organization and their NPI record was last updated 5 years ago. The authorized official of this NPI record is Mr. Charles Taylor Emt-i (Rescue Captain)

NPI
1114924206
Provider Name
LAUDERDALE-LAGRANGE FIRE DEPARTMENT, INC.
Entity Type
Organization
Location Address
W6080 US HIGHWAY 12 WHITEWATER, WI 53190
Location Phone
(262) 495-8400
Location Fax
(262) 495-8426
Mailing Address
W6080 US HIGHWAY 12 WHITEWATER, WI 53190
Mailing Phone
(262) 495-4658
Mailing Fax
(262) 495-8426
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-05-2005
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Ambulance Land Transport

Taxonomy Code
3416L0300X
Type
Transportation Services
License No.
60-00522
License State
WI

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. CHARLES TAYLOR EMT-I

Authorized Official Title
RESCUE CAPTAIN
Authorized Official Phone
(262) 495-4658

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
52D0930734
Facility Type
Ambulance
Certificate Effective Date
July 17, 2023
Certificate Expiration Date
July 16, 2025
Laboratory Director
CHARLES F. TAYLOR, CAPT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Lauderdale-lagrange Fire Department, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1114924206
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2124182820
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 2 + 4 + 1 + 8 + 2 + 8 + 2 + 0 + 24 = 54
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 54 = 66

The NPI number 1114924206 is valid because the calculated check digit 6 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1114924206, enumerated in the NPI registry as an "organization" on July 05, 2005

The provider is located at W6080 Us Highway 12 Whitewater, Wi 53190 and the phone number is (262) 495-8400

This medical organization specializes in Ambulance with taxonomy code 3416L0300X with a focus in Land Transport

The provider's CLIA number is 52D0930734 for a "ambulance" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on July 05, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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