Basic Information
| Provider Information | |||||||||
| NPI: | 1689295867 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CENTRAL AROOSTOOK COUNTY EMERGENCY MEDICAL SERVICE AUTHORITY | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CENTRAL AROOSTOOK AMBULANCE SERVICE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1820 | ||||||||
| Address2: | |||||||||
| City: | PRESQUE ISLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047691820 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2077647529 | ||||||||
| FaxNumber: | 2077646504 | ||||||||
| Practice Location | |||||||||
| Address1: | 150 MILITARY RD | ||||||||
| Address2: | |||||||||
| City: | BLAINE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 047344314 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2075406464 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/29/2020 | ||||||||
| LastUpdateDate: | 06/14/2022 | ||||||||
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| AuthorizedOfficialLastName: | FARLEY | ||||||||
| AuthorizedOfficialFirstName: | LEE | ||||||||
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| AuthorizedOfficialTitleorPosition: | AMBULANCE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 2075406464 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| NPICertificationDate: | 06/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | N | Transportation Services | Ambulance | 3416L0300X | Y | Transportation Services | Ambulance | Land Transport |
No ID Information.