Healthcare Provider Details

I. General information

NPI: 1053497313
Provider Name (Legal Business Name): TOWN OF BETHEL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2006
Last Update Date: 03/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

183 MAIN STREET
BETHEL ME
04217
US

IV. Provider business mailing address

PO BOX 1810
WINDHAM ME
04062-1810
US

V. Phone/Fax

Practice location:
  • Phone: 207-824-2669
  • Fax:
Mailing address:
  • Phone: 207-892-0020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number092
License Number StateME

VIII. Authorized Official

Name: JAMES G DOAR
Title or Position: TOWN MANAGER
Credential:
Phone: 207-824-2669