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General NPI Number Information
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NPI Number | 1437104908
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Entity Type | Organization
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Legal Business Name | NORTHSHORE AMBULANCE, INC.
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 07/14/2009
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Provider Practice Location Address
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Address Line | 63 GROVE STREET
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City | SALEM
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State | MA
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Zip | 01970
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Country | US
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Telephone | 617-599-4497
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 902 63 GROVE STREET
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City | SALEM
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State | MA
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Zip | 01970-5802
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Country | US
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Telephone | 617-599-4497
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT A DIONNE
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Credential |
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Telephone | 617-599-4497
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 3920
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License Number State | MA
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