Provider Demographics
NPI:1689841967
Name:CAPRON RESCUE SQUAD DISTRICT
Entity Type:Organization
Organization Name:CAPRON RESCUE SQUAD DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTANT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:A
Authorized Official - Last Name:STOLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-943-2402
Mailing Address - Street 1:51 N AYER ST
Mailing Address - Street 2:
Mailing Address - City:HARVARD
Mailing Address - State:IL
Mailing Address - Zip Code:60033-2859
Mailing Address - Country:US
Mailing Address - Phone:815-943-2402
Mailing Address - Fax:815-943-2403
Practice Address - Street 1:105 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CAPRON
Practice Address - State:IL
Practice Address - Zip Code:61012-7718
Practice Address - Country:US
Practice Address - Phone:815-943-2402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance