Healthcare Provider Details
I. General information
NPI: 1205803004
Provider Name (Legal Business Name): WINTERPORT FIRE AND RESCUE ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2006
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44 MAIN ST
WINTERPORT ME
04496-3225
US
IV. Provider business mailing address
PO BOX 724
WINTERPORT ME
04496-0724
US
V. Phone/Fax
- Phone: 207-554-9990
- Fax: 270-744-8642
- Phone: 207-505-7965
- Fax: 270-744-8642
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
WILLIAM
M
HAWKES
JR.
Title or Position: CHIEF
Credential:
Phone: 207-505-7965