Northern Tazewell Rescue Squad

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

22582 Issued in IL

Legal business name

NORTHERN TAZEWELL RESCUE SQUAD

Practice address

2445 Washington Rd
Washington, IL 61571-1761

Phone

(309) 698-4700

Fax

(309) 698-7885

NPI assigned

Feb 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David Houseworth

Title

Treasurer

Phone

(309) 698-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629113071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2445 WASHINGTON RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615711761",
            "telephone_number": "309-698-4700",
            "fax_number": "309-698-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2445 WASHINGTON RD",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615711761",
            "telephone_number": "309-698-4700",
            "fax_number": "309-698-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN TAZEWELL RESCUE SQUAD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOUSEWORTH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "309-698-4700"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "IL",
            "license": "22582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "09032026",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Washington, IL
• Providers in Washington, IL by specialty
• Land Ambulance in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.