MEDICARE: MCGREGOR MEMORIAL AMBULANCE 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	3416L0300X	Land Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	590008520	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	801271	OTHER	TUFTS HEALTH PLAN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	700387	OTHER	HARVARD PILGRIM
5	F434689	OTHER	OXFORD HEALTH PLANS
6	7106274Y0NH01	OTHER	ANTHEM BLUE CROSS

General Provider Information

NPI Number	:	1558350363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCGREGOR MEMORIAL AMBULANCE INC

Provider Business Mailing Address
First Line	:	47 COLLEGE RD
Second Line	:
City	:	DURHAM
State	:	NH
Zip	:	03824-2620
Country	:	US
Telephone Number	:	603-862-3674
Fax Number	:	603-862-4415

Provider Business Practice Location Address
First Line	:	47 COLLEGE RD
Second Line	:
City	:	DURHAM
State	:	NH
Zip	:	03824
Country	:	US
Telephone Number	:	603-862-3674
Fax Number	:	603-862-4415

Authorized Official
Title or Position	:	MANAGER
Name	:	CHRISTOPHER LEMELIN
Credential	:
Telephone Number	:	603-862-3674

Provider Enumeration Date	:	10/14/2005
Last Update Date	:	07/21/2022

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