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General NPI Number Information
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NPI Number | 1558399295
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Entity Type | Organization
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Legal Business Name | NORTHEAST MOBILE HEALTH SERVICES
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 10/07/2015
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Provider Practice Location Address
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Address Line | 24 WASHINGTON AVE
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City | SCARBOROUGH
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State | ME
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Zip | 04074-8311
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Country | US
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Telephone | 207-510-0073
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Fax | 207-883-5566
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Provider Business Mailing Address
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Address Line | 189 ODLIN RD
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City | BANGOR
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State | ME
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Zip | 04401-6703
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Country | US
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Telephone | 207-510-0073
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Fax | 207-885-5566
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | ROBERT E. RUSSELL III
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Credential |
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Telephone | 207-510-0073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 487
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 488
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License Number State | ME
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