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General NPI Number Information
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NPI Number | 1861457426
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Entity Type | Organization
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Legal Business Name | COLEMAN AREA RESCUE SQUAD INC.
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Dates
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Enumeration Date | 04/18/2006
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 119 E 16TH RD
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City | COLEMAN
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State | WI
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Zip | 54112-9412
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Country | US
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Telephone | 920-897-2858
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Fax | 920-897-4796
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Provider Business Mailing Address
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Address Line | 119 E 16TH RD
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City | COLEMAN
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State | WI
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Zip | 54112-9412
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Country | US
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Telephone | 920-897-2858
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Fax | 920-897-4796
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GAGE STRATTON RADLOFF
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Credential | EMT
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Telephone | 920-897-2858
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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 | 6000518
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License Number State | WI
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