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General NPI Number Information
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NPI Number | 1215984521
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Entity Type | Organization
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Legal Business Name | DELAVAN RESCUE SQUAD INC
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Dates
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Enumeration Date | 05/30/2006
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 651 ANN ST
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City | DELAVAN
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State | WI
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Zip | 53115
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Country | US
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Telephone | 262-728-9759
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Fax | 262-728-7666
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Provider Business Mailing Address
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Address Line | PO BOX 371 409 HALLBERG ST
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City | DELAVAN
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State | WI
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Zip | 53115
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Country | US
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Telephone | 262-728-9759
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Fax | 262-728-7666
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Authorized Official
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Title or Position | PRESIDENT CHIEF
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Name | MR. JOHN SCOTT KRAMER
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Credential |
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Telephone | 262-728-9759
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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