Provider Demographics
NPI:1861457426
Name:COLEMAN AREA RESCUE SQUAD INC.
Entity Type:Organization
Organization Name:COLEMAN AREA RESCUE SQUAD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:R
Authorized Official - Last Name:TISLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-897-2858
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:COLEMAN
Mailing Address - State:WI
Mailing Address - Zip Code:54112-0139
Mailing Address - Country:US
Mailing Address - Phone:920-897-2858
Mailing Address - Fax:920-897-4796
Practice Address - Street 1:119 E 16TH RD
Practice Address - Street 2:
Practice Address - City:COLEMAN
Practice Address - State:WI
Practice Address - Zip Code:54112-9412
Practice Address - Country:US
Practice Address - Phone:920-897-2858
Practice Address - Fax:920-897-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI60005183416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41335000Medicaid