MEDICARE: DANVILLE RESCUE SQUAD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	0504

General Provider Information

NPI Number	:	1518909159
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANVILLE RESCUE SQUAD INC

Provider Business Mailing Address
First Line	:	PO BOX 255
Second Line	:
City	:	DANVILLE
State	:	VT
Zip	:	05828-0255
Country	:	US
Telephone Number	:	802-684-9600
Fax Number	:	802-684-9611

Provider Business Practice Location Address
First Line	:	379 BRAINARD STREET
Second Line	:
City	:	DANVILLE
State	:	VT
Zip	:	05828-0255
Country	:	US
Telephone Number	:	802-684-9600
Fax Number	:	802-684-9611

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. GARY W SCHOENEMANN
Credential	:	RN EMT T 03
Telephone Number	:	802-684-9600

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	08/22/2020

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