Provider Demographics
NPI:1770618514
Name:SENECA VOLUNTEER AMBULANCE SQUAD
Entity type:Organization
Organization Name:SENECA VOLUNTEER AMBULANCE SQUAD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSMOND
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P
Authorized Official - Phone:815-357-8504
Mailing Address - Street 1:PO BOX 674
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:IL
Mailing Address - Zip Code:61360-0674
Mailing Address - Country:US
Mailing Address - Phone:815-357-8504
Mailing Address - Fax:815-357-3243
Practice Address - Street 1:303 N CASH
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:IL
Practice Address - Zip Code:61360-9010
Practice Address - Country:US
Practice Address - Phone:815-357-8504
Practice Address - Fax:815-357-3243
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance