Healthcare Provider Details

I. General information

NPI: 1689776940
Provider Name (Legal Business Name): TOWN OF LIMERICK
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 02/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 SCHOOL ST
LIMERICK ME
04048
US

IV. Provider business mailing address

P.O. BOX 1810
WINDHAM ME
04062-1810
US

V. Phone/Fax

Practice location:
  • Phone: 207-793-2687
  • Fax: 207-793-3468
Mailing address:
  • Phone: 207-892-0020
  • Fax: 207-893-0583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number31150
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0418
License Number StateME

VIII. Authorized Official

Name: PETER PROCTOR
Title or Position: CHIEF
Credential:
Phone: 207-793-2687