Provider Demographics
NPI:1376762864
Name:HARDWICK RESCUE & EMERGENCY SQUAD, INC
Entity Type:Organization
Organization Name:HARDWICK RESCUE & EMERGENCY SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:GASCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-450-3878
Mailing Address - Street 1:PO BOX 447
Mailing Address - Street 2:
Mailing Address - City:GILBERTVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01031-0447
Mailing Address - Country:US
Mailing Address - Phone:413-477-0008
Mailing Address - Fax:
Practice Address - Street 1:482 LOWER ROAD
Practice Address - Street 2:
Practice Address - City:GILBERTVILLE
Practice Address - State:MA
Practice Address - Zip Code:01031-0447
Practice Address - Country:US
Practice Address - Phone:413-477-0008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1716069Medicaid
MA076559OtherBLUECROSS
MA019259Medicare ID - Type UnspecifiedMEDICARE ID