Provider Demographics
NPI:1295852713
Name:UNITED AREA RESCUE SQUAD,INC.
Entity Type:Organization
Organization Name:UNITED AREA RESCUE SQUAD,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:ERIC-DAVID
Authorized Official - Last Name:LLANAS
Authorized Official - Suffix:
Authorized Official - Credentials:AEMT
Authorized Official - Phone:715-499-0499
Mailing Address - Street 1:PO BOX 102
Mailing Address - Street 2:
Mailing Address - City:WABENO
Mailing Address - State:WI
Mailing Address - Zip Code:54566-0102
Mailing Address - Country:US
Mailing Address - Phone:715-889-4793
Mailing Address - Fax:
Practice Address - Street 1:4575 SMITH ST
Practice Address - Street 2:
Practice Address - City:WABENO
Practice Address - State:WI
Practice Address - Zip Code:54566-9172
Practice Address - Country:US
Practice Address - Phone:715-889-4793
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60003103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41337100Medicaid
WI85373Medicare NSC