MEDICARE: CITY OF AUBURN

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	3416L0300X	Land Ambulance	038	ME

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	038703	OTHER	ME	BLUE CROSS

General Provider Information

NPI Number	:	1932165453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF AUBURN

Provider Business Mailing Address
First Line	:	PO BOX 1810
Second Line	:
City	:	WINDHAM
State	:	ME
Zip	:	04062-1810
Country	:	US
Telephone Number	:	207-892-0020
Fax Number	:	207-893-0583

Provider Business Practice Location Address
First Line	:	550 MINOT AVE
Second Line	:
City	:	AUBURN
State	:	ME
Zip	:	04210-4390
Country	:	US
Telephone Number	:	207-784-5433
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	FRANK ROMA
Credential	:
Telephone Number	:	207-784-4533

Provider Enumeration Date	:	04/24/2006
Last Update Date	:	10/02/2014

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Directions to “CITY OF AUBURN ” Practice Location

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