Provider Demographics
NPI:1144350067
Name:NORTH CRAWFORD RESCUE SQUAD, INC.
Entity type:Organization
Organization Name:NORTH CRAWFORD RESCUE SQUAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASIRER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BONNIE
Authorized Official - Middle Name:L
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-624-5226
Mailing Address - Street 1:102 LEGION DR.
Mailing Address - Street 2:BOX 37
Mailing Address - City:SOLDIERS GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:54655-0037
Mailing Address - Country:US
Mailing Address - Phone:608-624-5226
Mailing Address - Fax:608-624-5732
Practice Address - Street 1:102 LEGION DR.
Practice Address - Street 2:
Practice Address - City:SOLDIERS GROVE
Practice Address - State:WI
Practice Address - Zip Code:54655-0037
Practice Address - Country:US
Practice Address - Phone:608-624-5226
Practice Address - Fax:608-624-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60-00994341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI83-419Medicare PIN