Healthcare Provider Details

I. General information

NPI: 1730125824
Provider Name (Legal Business Name): SACOPEE RESCUE UNIT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 03/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ALLARD CIRCLE
HIRAM ME
04041-9999
US

IV. Provider business mailing address

PO BOX 1810
WINDHAM ME
04062-1810
US

V. Phone/Fax

Practice location:
  • Phone: 207-625-3088
  • Fax:
Mailing address:
  • Phone: 207-892-0020
  • Fax: 207-893-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number600
License Number StateME

VIII. Authorized Official

Name: LORIE ELGERLY
Title or Position: RESCUE CHIEF
Credential:
Phone: 207-625-3088