Healthcare Provider Details

I. General information

NPI: 1326021155
Provider Name (Legal Business Name): PETIT MANAN AMBULANCE CORPS INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2005
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 SCHOOL ST.
MILBRIDGE ME
04658
US

IV. Provider business mailing address

P.O. BOX 188 18 SCHOOL ST.
MILBRIDGE ME
04658
US

V. Phone/Fax

Practice location:
  • Phone: 207-546-2254
  • Fax: 207-546-2254
Mailing address:
  • Phone: 207-546-2254
  • Fax: 207-546-2254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number537
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number537
License Number StateME

VIII. Authorized Official

Name: MRS. NANCY S. PARRITT
Title or Position: DIRECTOR/SERVICE REP
Credential: EMTI
Phone: 207-546-7038