NORTHERN TAZEWELL RESCUE SQUAD (NPI# 1629113071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629113071 |
| Entity Type | Organization |
| Organization Name | NORTHERN TAZEWELL RESCUE SQUAD |
| Practice Address |
2445 Washington Rd Washington IL 61571-1761 |
| Practice Telephone | 3096984700 |
| Practice Fax Number | 3096987885 |
| Mailing Telephone | 3096984700 |
| Mailing Fax Number | 3096987885 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID HOUSEWORTH (TREASURER) |
| Authorized Official Telephone | 3096984700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
22582 | IL | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 09032026 | 01 |
| Street Address |
2445 WASHINGTON RD |
| City | WASHINGTON |
| State | IL |
| Zip Code | 61571-1761 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904504 | Kelly Hornberger | Physical Therapist | 1201 Newcastle Rd., Washington, IL 61571 | 2018-09-01 |
| 1073050407 | Jillyn Cross | Occupational Therapist | 14 Oxford Court, Washington, IL 61571 | 2017-01-24 |
| 1639410772 | Stephen L Dejaynes | Counselor | 100 Hillcrest Drive, Washington, IL 61571 | 2013-03-14 |
| 1184998692 | One Counseling and Wellness | Counselor | 1003 North Cummings Lane, Washington, IL 61571 | 2012-03-01 |
| 1871878371 | M Lisa Kim | Pharmacist | 1700 Saddleridge Ct, Washington, IL 61571 | 2011-10-15 |
| 1073805156 | Skill Sprout International | Behavioral Analyst | 102 Walnut Street, Washington, IL 61571 | 2011-05-09 |
| 1659600948 | Skill Sprout, LLC | Behavioral Analyst | 128 Washington Square, Washington, IL 61571 | 2009-12-15 |
| 1700024916 | Julie Adams | Developmental Therapist | 700 S. Elm, Washington, IL 61571 | 2009-01-26 |
| 1851595128 | Michael John Herman | Dentist | 106 So Cummings Lane, Washington, IL 61571 | 2007-06-12 |
| 1861539132 | Gary Lee Cunningham | Dentist | 5 Laurel Ct., Washington, IL 61571 | 2007-01-30 |
| Find all providers in zip 61571 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| 1518170513 | Town of Washington, Washington Rescue Squad | Ambulance | 75 Lempster Mtn Road, Washington, NH 03280 | 2007-05-07 |
| 1699803627 | Sdtm Investments Inc | Ambulance | 425 Grimes Rd, Washington, NC 27889-4007 | 2007-03-01 |
| 1013060755 | Southwest Medical Services Inc | Ambulance | 210 S Meridian St, Washington, IN 47501 | 2007-01-18 |
| 1992805022 | Government of The District of Columbia Office of Tax and Revenue | Ambulance | 2000 14th St Nw, Suite 500, Washington, DC 20009-4473 | 2006-09-25 |
| 1083719801 | American Medical Response Mid-atlantic Inc | Ambulance | 3325 V St Ne, Washington, DC 20018-1526 | 2006-09-14 |
| 1912926106 | Washington Emergency Services, Inc. | Ambulance | 100 Belvidere Ave, Washington, NJ 07882-1417 | 2006-07-19 |
| 1376576918 | Washington Volunteer Fire Department and Rescue Squad Inc | Ambulance | 200 N Wilmore Rd, Washington, IL 61571-1249 | 2006-07-08 |
| 1659302693 | Washington Area Ambulance District | Ambulance | 515 Washington Ave, Washington, MO 63090-3317 | 2006-07-06 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 61571 |
Please comment or provide details below to improve the information on NORTHERN TAZEWELL RESCUE SQUAD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.