Healthcare Provider Details

I. General information

NPI: 1285639393
Provider Name (Legal Business Name): CITY OF SANFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2005
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

972 MAIN ST
SANFORD ME
04073-3509
US

IV. Provider business mailing address

972 MAIN ST
SANFORD ME
04073-3509
US

V. Phone/Fax

Practice location:
  • Phone: 207-324-9160
  • Fax: 207-324-5672
Mailing address:
  • Phone: 207-324-9160
  • Fax: 207-324-5672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number610
License Number StateME

VIII. Authorized Official

Name: STEVE BENOTTI
Title or Position: FIRE CHIEF
Credential:
Phone: 207-324-9160