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General NPI Number Information
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NPI Number | 1811913312
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Entity Type | Organization
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Legal Business Name | BURLINGTON RESCUE SQUAD, INC.
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Dates
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Enumeration Date | 07/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 165 W WASHINGTON ST
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City | BURLINGTON
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State | WI
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Zip | 53105-1445
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Country | US
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Telephone | 262-763-9521
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 501
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City | BURLINGTON
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State | WI
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Zip | 53105-0501
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Country | US
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Telephone | 262-763-9521
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Fax | 262-763-9521
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Authorized Official
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Title or Position | TREASURER
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Name | MR. LESTER O MASTLIR II
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Credential |
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Telephone | 262-763-9521
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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 | 1213-800
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License Number State | WI
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