Organization
NORTHERN TAZEWELL RESCUE SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID HOUSEWORTH (TREASURER)
(309) 698-4700
Entity
Organization
Contact information
Practice address
2445 WASHINGTON RD, WASHINGTON, IL 61571-1761
(309) 698-4700
(309) 698-7885
Mailing address
2445 WASHINGTON RD, WASHINGTON, IL 61571-1761
(309) 698-4700
(309) 698-7885
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
22582
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09032026
BCBS
IL
Enumeration date
02/21/2007
Last updated
08/22/2020
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