Provider Demographics
NPI:1265623573
Name:WADDINGTON RESCUE SQUAD INC
Entity type:Organization
Organization Name:WADDINGTON RESCUE SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCBATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-388-5641
Mailing Address - Street 1:8610 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-4755
Mailing Address - Country:US
Mailing Address - Phone:716-204-3350
Mailing Address - Fax:860-563-3403
Practice Address - Street 1:48 MAPLE STREET
Practice Address - Street 2:
Practice Address - City:WADDINGTON
Practice Address - State:NY
Practice Address - Zip Code:13694-0331
Practice Address - Country:US
Practice Address - Phone:315-388-5641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12267341600000X
NY343863416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02973884Medicaid
NY02973884Medicaid