Healthcare Provider Details

I. General information

NPI: 1093909699
Provider Name (Legal Business Name): TOWN OF WARREN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 08/03/2021
Certification Date: 08/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 WESTERN RD
WARREN ME
04864-4279
US

IV. Provider business mailing address

167 WESTERN RD
WARREN ME
04864-4279
US

V. Phone/Fax

Practice location:
  • Phone: 207-354-2278
  • Fax: 207-273-3373
Mailing address:
  • Phone: 207-354-2278
  • Fax: 207-273-3373

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number733
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MS. POLLY WOOD
Title or Position: AMBULANCE DIRECTOR
Credential:
Phone: 207-354-2278