Healthcare Provider Details

I. General information

NPI: 1912950270
Provider Name (Legal Business Name): DELAVAN RESCUE SQUAD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

651 ANN ST
DELAVAN WI
53115-1840
US

IV. Provider business mailing address

PO BOX 371
DELAVAN WI
53115-0371
US

V. Phone/Fax

Practice location:
  • Phone: 262-728-9759
  • 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: JOHN KRAMER
Title or Position: CHIEF
Credential:
Phone: 262-728-9759