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General NPI Number Information
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NPI Number | 1497308563
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Entity Type | Organization
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Legal Business Name | SEACOAST AMBULANCE LLC
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 69 VENTURE DR
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City | DOVER
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State | NH
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Zip | 03820-5929
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Country | US
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Telephone | 561-542-4233
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Fax |
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Provider Business Mailing Address
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Address Line | 1 NICHOLAS CIR
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City | DOVER
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State | NH
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Zip | 03820-6011
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Country | US
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Telephone | 561-542-4233
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JUSTIN LEE PETRONELLI
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Credential | PARAMEDIC
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Telephone | 561-542-4233
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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 |
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License Number State |
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