Healthcare Provider Details

I. General information

NPI: 1487608295
Provider Name (Legal Business Name): TWIN BRIDGE RESCUE SQUAD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W11280 COUNTY ROAD X
CRIVITZ WI
54114-8004
US

IV. Provider business mailing address

PO BOX 745
CRIVITZ WI
54114-0745
US

V. Phone/Fax

Practice location:
  • Phone: 715-854-2942
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: ELAINE OLSON
Title or Position: PRESIDENT
Credential:
Phone: 715-854-2942