Healthcare Provider Details

I. General information

NPI: 1548338866
Provider Name (Legal Business Name): FIRST BRANCH AMBULANCE SERVICE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 VT RT 110
CHELSEA VT
05038
US

IV. Provider business mailing address

PO BOX 74
CHELSEA VT
05038-0074
US

V. Phone/Fax

Practice location:
  • Phone: 802-685-3112
  • Fax:
Mailing address:
  • Phone: 802-889-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0805
License Number StateVT

VIII. Authorized Official

Name: MRS. JACKIE M. HIGGINS
Title or Position: ACCOUNTS MANAGER
Credential:
Phone: 802-889-9800