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General NPI Number Information
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NPI Number | 1295852713
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Entity Type | Organization
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Legal Business Name | UNITED AREA RESCUE SQUAD,INC.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 03/12/2015
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Provider Practice Location Address
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Address Line | 4575 SMITH ST
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City | WABENO
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State | WI
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Zip | 54566-9172
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Country | US
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Telephone | 715-889-4793
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 102
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City | WABENO
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State | WI
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Zip | 54566-0102
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Country | US
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Telephone | 715-889-4793
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Fax |
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Authorized Official
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Title or Position | ASSISTANT CHIEF
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Name | MR. JONATHON ERIC-DAVID LLANAS
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Credential | AEMT
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Telephone | 715-499-0499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 6000310
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License Number State | WI
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