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General NPI Number Information
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NPI Number | 1427060474
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Entity Type | Organization
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Legal Business Name | HERMANSVILLE RESCUE SQUAD AND AMBULANCE SERVICE
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/29/2018
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Provider Practice Location Address
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Address Line | W5468 FIRST STREET
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City | HERMANSVILLE
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State | MI
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Zip | 49847
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Country | US
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Telephone | 906-498-2336
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Fax |
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Provider Business Mailing Address
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Address Line | 828 SHERIDAN RD P.O. BOX 415
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City | ESCANABA
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State | MI
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Zip | 49829-1531
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Country | US
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Telephone | 906-786-2051
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Fax |
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Authorized Official
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Title or Position | BILLING AGENT
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Name | ROBERT P MANSON
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Credential |
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Telephone | 906-786-2051
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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 | 551002
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License Number State | MI
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