Organization
BLACK CREEK RESCUE SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY PASCH EMT-I (COORIDINATORFINANCIAL SECRETARY)
(920) 213-1513
Entity
Organization
Contact information
Practice address
W5200 COUNTY RD B, BLACK CREEK, WI 54106
(920) 984-3444
(920) 984-9395
Mailing address
W5200 COUNTY RD B, PO BOX 143, BLACK CREEK, WI 54106
(920) 984-3444
(920) 984-9395
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
60-01367
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41305100
—
WI
Enumeration date
07/08/2006
Last updated
08/22/2020
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