Provider Demographics
NPI:1528279676
Name:HARTSVILLE RESCUE SQUAD INC
Entity type:Organization
Organization Name:HARTSVILLE RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ASTRALLA
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-I
Authorized Official - Phone:843-307-0591
Mailing Address - Street 1:305 MARLBORO AVE
Mailing Address - Street 2:PO BOX 2094
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4539
Mailing Address - Country:US
Mailing Address - Phone:843-383-9326
Mailing Address - Fax:
Practice Address - Street 1:305 MARLBORO AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4539
Practice Address - Country:US
Practice Address - Phone:843-383-9326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC190341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance