Healthcare Provider Details

I. General information

NPI: 1659927739
Provider Name (Legal Business Name): HOUSTON RESCUE SQUAD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 07/15/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5125 RUSSIA HOUSTON RD
HOUSTON OH
45333-9802
US

IV. Provider business mailing address

PO BOX 397
HOUSTON OH
45333-0397
US

V. Phone/Fax

Practice location:
  • Phone: 937-541-2210
  • Fax:
Mailing address:
  • Phone: 937-821-0059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. BRIAN K HATHAWAY
Title or Position: MANAGER
Credential:
Phone: 937-821-0059