=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417023532
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ARLINGTON RESCUE SQUAD INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/28/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 66 CHITTENDEN DR.
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05250
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-375-6589
-----------------------------------------------------
Fax | 802-375-2716
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 66 CHITTENDEN DR.
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | VT
-----------------------------------------------------
Zip | 05250
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 802-375-6589
-----------------------------------------------------
Fax | 802-375-2716
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | BILLING COORDINATOR
-----------------------------------------------------
Name | MR. JOSEPH T ROBERTS
-----------------------------------------------------
Credential | EMT-I
-----------------------------------------------------
Telephone | 802-375-6589
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | 1201
-----------------------------------------------------
License Number State | VT
-----------------------------------------------------