Healthcare Provider Details

I. General information

NPI: 1215979653
Provider Name (Legal Business Name): TOWN OF RICHFORD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 MAIN ST RICHFORD AMBULANCE SERVICE
RICHFORD VT
05476
US

IV. Provider business mailing address

PO BOX 236 RICHFORD AMBULANCE SERVICE
RICHFORD VT
05476
US

V. Phone/Fax

Practice location:
  • Phone: 802-848-7751
  • Fax: 802-848-7752
Mailing address:
  • Phone: 802-848-7751
  • Fax: 802-848-7752

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KILEY DEUSO
Title or Position: TOWN CLERK/TREASURER
Credential:
Phone: 802-848-7751