Healthcare Provider Details

I. General information

NPI: 1518163450
Provider Name (Legal Business Name): TOWN OF CUSHING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2007
Last Update Date: 09/29/2021
Certification Date: 09/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39 CROSS RD
CUSHING ME
04563-3100
US

IV. Provider business mailing address

39 CROSS RD
CUSHING ME
04563-3100
US

V. Phone/Fax

Practice location:
  • Phone: 207-354-2375
  • Fax: 207-354-1375
Mailing address:
  • Phone: 207-354-2375
  • Fax: 207-354-1375

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number195
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: LISA YOUNG
Title or Position: TREASURER
Credential:
Phone: 207-354-2375