Healthcare Provider Details

I. General information

NPI: 1952478737
Provider Name (Legal Business Name): TOWN OF MADAWASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 MAIN ST
MADAWASKA ME
04756-1105
US

IV. Provider business mailing address

PO BOX 1820
PRESQUE ISLE ME
04769-1820
US

V. Phone/Fax

Practice location:
  • Phone: 207-728-6126
  • Fax: 207-728-3618
Mailing address:
  • Phone: 207-764-7529
  • Fax: 207-764-6504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number437
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: GARY PICARD
Title or Position: TOWN MANAGER
Credential:
Phone: 207-728-6351