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NPI 1881025310

NPI 1881025310 : TOWN OF NEW GLOUCESTER : NEW GLOUCESTER, ME

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General NPI Number Information
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    NPI Number           |    1881025310
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    Entity Type          |    Organization 
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    Legal Business Name  |    TOWN OF NEW GLOUCESTER 
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Dates
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    Enumeration Date     |    12/10/2013
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    Last Update Date     |    03/16/2016
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Provider Practice Location Address
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    Address Line         |    611 LEWISTON ROAD 
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    City                 |    NEW GLOUCESTER
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    State                |    ME
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    Zip                  |    04260-3818
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    Country              |    US
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    Telephone            |    207-926-4142
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 1810 
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    City                 |    WINDHAM
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    State                |    ME
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    Zip                  |    04062-1810
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    Country              |    US
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    Telephone            |    207-892-0020
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    Fax                  |    207-893-0583
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Authorized Official
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    Title or Position    |    DEPUTY TREASURER
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    Name                 |     LORI-ANNE  WILSON 
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    Credential           |    
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    Telephone            |    207-926-4126
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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       |    937
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    License Number State |    ME
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Taxonomy #2
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    Taxonomy Code        |    3416L0300X
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    Taxonomy Name        |    Land Ambulance
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    License Number       |    0937
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    License Number State |    ME
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