MEDICARE: MIDDLEBURY VOLUNTEER AMBULANCE ASSOCIATION, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	0703	VT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	05948931	OTHER	VT	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1861594707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDDLEBURY VOLUNTEER AMBULANCE ASSOCIATION, INC

Provider Business Mailing Address
First Line	:	PO BOX 153
Second Line	:	CO NEAB
City	:	VERGENNES
State	:	VT
Zip	:	05491-0153
Country	:	US
Telephone Number	:	802-877-2429
Fax Number	:	802-877-2292

Provider Business Practice Location Address
First Line	:	55 COLLINS DR
Second Line	:
City	:	MIDDLEBURY
State	:	VT
Zip	:	05753-8503
Country	:	US
Telephone Number	:	802-388-3286
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. KEVIN PARIZO
Credential	:
Telephone Number	:	802-388-3286

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	11/17/2023

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