Provider Demographics
NPI:1609849686
Name:BRANDON AREA RESCUE SQUAD, INC
Entity Type:Organization
Organization Name:BRANDON AREA RESCUE SQUAD, INC
Other - Org Name:BRANDON AREA RESCUE SQUAD, INC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KILPECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-247-3231
Mailing Address - Street 1:PO BOX 232
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:VT
Mailing Address - Zip Code:05733-0232
Mailing Address - Country:US
Mailing Address - Phone:802-247-3231
Mailing Address - Fax:802-247-3916
Practice Address - Street 1:1338 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:VT
Practice Address - Zip Code:05733-4409
Practice Address - Country:US
Practice Address - Phone:802-247-3231
Practice Address - Fax:802-247-3916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-09
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0AM0010Medicaid
AM0010Medicare PIN