Provider Demographics
NPI:1316982465
Name:UNITED RESCUE SERVICE
Entity type:Organization
Organization Name:UNITED RESCUE SERVICE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:KEITH
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-539-6331
Mailing Address - Street 1:PO BOX 577
Mailing Address - Street 2:229 E BEECH
Mailing Address - City:HARRISON
Mailing Address - State:MI
Mailing Address - Zip Code:48625
Mailing Address - Country:US
Mailing Address - Phone:989-539-6331
Mailing Address - Fax:989-539-9121
Practice Address - Street 1:229 W BEECH ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:MI
Practice Address - Zip Code:48625
Practice Address - Country:US
Practice Address - Phone:989-539-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1810023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI590A800030OtherBLUE CROSS BLUE SHIELD
MI3003300Medicaid
590058481OtherRAILROAD MEDICARE
MI3003300Medicaid