Provider Demographics
NPI:1568507655
Name:COMMUNITY RESCUE SERVICE, INC
Entity Type:Organization
Organization Name:COMMUNITY RESCUE SERVICE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:VAY
Authorized Official - Last Name:CLOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-733-1112
Mailing Address - Street 1:110 EASTERN BLVD N
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5843
Mailing Address - Country:US
Mailing Address - Phone:301-733-1112
Mailing Address - Fax:301-739-6015
Practice Address - Street 1:110 EASTERN BLVD N
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5843
Practice Address - Country:US
Practice Address - Phone:301-733-1112
Practice Address - Fax:301-739-6015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDDN86Medicare ID - Type Unspecified