Provider Demographics
NPI:1447372271
Name:TOWN OF VINALHAVEN
Entity type:Organization
Organization Name:TOWN OF VINALHAVEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWN MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:STRATTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-863-2042
Mailing Address - Street 1:PO BOX 815
Mailing Address - Street 2:
Mailing Address - City:VINALHAVEN
Mailing Address - State:ME
Mailing Address - Zip Code:04863-0815
Mailing Address - Country:US
Mailing Address - Phone:207-863-2042
Mailing Address - Fax:
Practice Address - Street 1:56 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:VINALHAVEN
Practice Address - State:ME
Practice Address - Zip Code:04863
Practice Address - Country:US
Practice Address - Phone:207-863-2042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3673416A0800X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No3416A0800XTransportation ServicesAmbulanceAir Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME137890300Medicaid
ME703875Medicare ID - Type UnspecifiedMEDICARE