Healthcare Provider Details

I. General information

NPI: 1639643125
Provider Name (Legal Business Name): ORRS AND BAILEY ISLANDS FIRE DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2019
Last Update Date: 03/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HARPSWELL ISLAND RD
ORR'S ISLAND ME
04066
US

IV. Provider business mailing address

PO BOX 1810
WINDHAM ME
04062-1810
US

V. Phone/Fax

Practice location:
  • Phone: 207-833-5405
  • Fax:
Mailing address:
  • Phone: 207-892-0020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN A WALLACE JR.
Title or Position: CHIEF
Credential:
Phone: 207-833-5405