Healthcare Provider Details

I. General information

NPI: 1043330947
Provider Name (Legal Business Name): TOWN OF CLINTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 BAKER ST
CLINTON ME
04927-3551
US

IV. Provider business mailing address

27 BAKER ST
CLINTON ME
04927-3551
US

V. Phone/Fax

Practice location:
  • Phone: 800-964-9200
  • Fax:
Mailing address:
  • Phone: 800-964-9200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number160
License Number StateME

VIII. Authorized Official

Name: GARY PETLEY
Title or Position: FIRE CHIEF
Credential:
Phone: 800-964-9200