Provider Demographics
NPI:1053505354
Name:BARNEVELD AREA RESCUE SQUAD, INC
Entity Type:Organization
Organization Name:BARNEVELD AREA RESCUE SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-924-3811
Mailing Address - Street 1:403 BUSINESS ID
Mailing Address - Street 2:
Mailing Address - City:BARNEVELD
Mailing Address - State:WI
Mailing Address - Zip Code:53507-9752
Mailing Address - Country:US
Mailing Address - Phone:608-924-2904
Mailing Address - Fax:
Practice Address - Street 1:403 BUSINESS ID
Practice Address - Street 2:
Practice Address - City:BARNEVELD
Practice Address - State:WI
Practice Address - Zip Code:53507-9752
Practice Address - Country:US
Practice Address - Phone:608-924-2904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI601179341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41305800Medicaid