Provider Demographics
NPI:1083128490
Name:CHARLES COUNTY RESCUE SQUAD INC
Entity Type:Organization
Organization Name:CHARLES COUNTY RESCUE SQUAD INC
Other - Org Name:CHARLES COUNTY VOLUNTEER RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-479-4790
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-0247
Mailing Address - Country:US
Mailing Address - Phone:410-479-4790
Mailing Address - Fax:410-479-4793
Practice Address - Street 1:2 CALVERT ST
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646
Practice Address - Country:US
Practice Address - Phone:301-934-4434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport