Provider Demographics
NPI:1447237557
Name:OTIS RESCUE SQUAD, INC
Entity Type:Organization
Organization Name:OTIS RESCUE SQUAD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMT COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-269-4409
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:15 S MAIN RD
Practice Address - Street 2:
Practice Address - City:OTIS
Practice Address - State:MA
Practice Address - Zip Code:01253
Practice Address - Country:US
Practice Address - Phone:413-269-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-29
Last Update Date:2013-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3363341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
356215OtherMVP HEALTH CARE
613359Other21ST CENTURY HEALTH
MA1713809Medicaid
613359OtherTUFTS HEALTH PLAN
MA017759OtherBLUE CROSS BLUE SHIELD
590007485OtherRR MEDICARE
703177OtherHARVARD PILGRIM
000000025869OtherBMC HEALTHNET PLAN
MA1713809Medicaid