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General NPI Number Information
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NPI Number | 1194814335
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Entity Type | Organization
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Legal Business Name | KENOSHA COUNTY SCOUT LEADERS RESCUE SQUAD, INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 3019 45TH ST
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City | KENOSHA
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State | WI
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Zip | 53144-1647
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Country | US
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Telephone | 262-652-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 3019 45TH ST
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City | KENOSHA
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State | WI
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Zip | 53144-1647
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Country | US
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Telephone | 262-652-2041
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Fax |
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Authorized Official
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Title or Position | ASSISTANT CHIEF - BOARD PRESIDENT
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Name | MR. MICHAEL L KURHAJEC
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Credential | EMT
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Telephone | 262-652-2041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 6000282
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License Number State | WI
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