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General NPI Number Information
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NPI Number | 1730331356
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Entity Type | Organization
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Legal Business Name | LEWISVILLE RESCUE SQUAD
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Dates
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Enumeration Date | 10/14/2008
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Last Update Date | 08/12/2015
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Provider Practice Location Address
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Address Line | 208 LEWIS STREET W
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City | LEWISVILLE
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State | MN
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Zip | 56060
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Country | US
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Telephone | 507-435-2451
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 142
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City | LEWISVILLE
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State | MN
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Zip | 56060-0142
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Country | US
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Telephone | 507-435-2451
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Fax |
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Authorized Official
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Title or Position | AMBULANCE DIRECTOR
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Name | DAVID ZENK
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Credential |
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Telephone | 507-435-4231
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 0136
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License Number State | MN
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