Healthcare Provider Details
I. General information
NPI: 1225153224
Provider Name (Legal Business Name): CITY OF BIDDEFORD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2007
Last Update Date: 06/07/2021
Certification Date: 06/07/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
152 ALFRED ST
BIDDEFORD ME
04005-3249
US
IV. Provider business mailing address
152 ALFRED ST
BIDDEFORD ME
04005-3249
US
V. Phone/Fax
- Phone: 207-282-6632
- Fax: 207-283-8243
- Phone: 207-571-1684
- Fax: 207-283-8243
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 100 |
| License Number State | ME |
VIII. Authorized Official
Name:
KATHY
BOYDEN
Title or Position: OFFICE MANAGER
Credential:
Phone: 207-571-1684