MEDICARE: ESSEX RESCUE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance
2	3416L0300X	Land Ambulance	0304	VT

General Provider Information

NPI Number	:	1144203852
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESSEX RESCUE INC

Provider Business Mailing Address
First Line	:	1 EDUCATIONAL DR
Second Line	:
City	:	ESSEX JUNCTION
State	:	VT
Zip	:	05452-3172
Country	:	US
Telephone Number	:	800-488-4351
Fax Number	:	978-356-2721

Provider Business Practice Location Address
First Line	:	1 EDUCATIONAL DR
Second Line	:
City	:	ESSEX JUNCTION
State	:	VT
Zip	:	05452-3172
Country	:	US
Telephone Number	:	802-878-4859
Fax Number	:	802-878-1246

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. COLLEEN MARIE BALLARD
Credential	:	EMT
Telephone Number	:	802-878-4859

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	02/09/2023

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