Healthcare Provider Details

I. General information

NPI: 1619156809
Provider Name (Legal Business Name): WEST BROOKFIELD RESCUE SQUAD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 W MAIN ST
WEST BROOKFIELD MA
01585-2878
US

IV. Provider business mailing address

19 NORFOLK AVE STE B
SOUTH EASTON MA
02375-1911
US

V. Phone/Fax

Practice location:
  • Phone: 508-637-1778
  • Fax:
Mailing address:
  • Phone: 888-771-6115
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3319
License Number StateMA

VIII. Authorized Official

Name: DANIEL MCCALL
Title or Position: CHIEF
Credential:
Phone: 508-637-1778