Healthcare Provider Details

I. General information

NPI: 1902068885
Provider Name (Legal Business Name): TOWN OF DENNYSVILLE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 KING STREET
DENNYSVILLE ME
04628
US

IV. Provider business mailing address

1935 US RTE 1
EDMUNDS TWP ME
04628-5412
US

V. Phone/Fax

Practice location:
  • Phone: 207-726-4006
  • Fax:
Mailing address:
  • Phone: 207-726-4674
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number220
License Number StateME

VIII. Authorized Official

Name: MR. WAYNE L SEELEY
Title or Position: CHIEF VOLUNTEER
Credential: EMT-B
Phone: 207-726-4674