Healthcare Provider Details

I. General information

NPI: 1841412723
Provider Name (Legal Business Name): CITY OF SACO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2007
Last Update Date: 12/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 THORNTON AVE
SACO ME
04072-2721
US

IV. Provider business mailing address

300 MAIN ST
SACO ME
04072-1515
US

V. Phone/Fax

Practice location:
  • Phone: 207-282-3244
  • Fax: 207-282-8203
Mailing address:
  • Phone: 207-282-3244
  • Fax: 207-282-8203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number595
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number595
License Number StateME

VIII. Authorized Official

Name: MRS. CHERYL DAWN FOURNIER
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 208-282-1032