Healthcare Provider Details

I. General information

NPI: 1881919363
Provider Name (Legal Business Name): ROYALTON FIRE DISTRICT 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/29/2010
Last Update Date: 10/01/2021
Certification Date: 10/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 SAFFORD STREET
SOUTH ROYALTON VT
05068
US

IV. Provider business mailing address

PO BOX 482
SOUTH ROYALTON VT
05068-0482
US

V. Phone/Fax

Practice location:
  • Phone: 802-763-8606
  • Fax:
Mailing address:
  • Phone: 802-763-8606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number85671
License Number StateVT

VIII. Authorized Official

Name: STEPHEN SANBORN
Title or Position: SUPERVISOR
Credential: OPERATION SUPERVISOR
Phone: 802-788-1050