=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346166006
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN H GILBOY III PARAMEDIC
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/26/2026
-----------------------------------------------------
Last Update Date | 06/26/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 136 SACO AVE
-----------------------------------------------------
City | OLD ORCHARD BEACH
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04064-1614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-710-8119
-----------------------------------------------------
Fax | 207-934-1750
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 136 SACO AVE
-----------------------------------------------------
City | OLD ORCHARD BEACH
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04064-1614
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-710-8119
-----------------------------------------------------
Fax | 207-934-1750
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207PE0004X
-----------------------------------------------------
Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
-----------------------------------------------------
License Number | 500
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------