Healthcare Provider Details

I. General information

NPI: 1265119408
Provider Name (Legal Business Name): TOWN OF ST. GEORGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SCHOOL STREET 3 SCHOOL STREET
TENANTS HARBOR ME
04860
US

IV. Provider business mailing address

PO BOX 131
TENANTS HARBOR ME
04860-0131
US

V. Phone/Fax

Practice location:
  • Phone: 207-372-6363
  • Fax:
Mailing address:
  • Phone: 207-322-2309
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMY DYER DRINKWATER
Title or Position: EMS DIRECTOR
Credential: PARAMEDIC
Phone: 207-372-6363