Provider Demographics
NPI:1871618256
Name:VAN BUREN AMBULANCE SERVICE
Entity type:Organization
Organization Name:VAN BUREN AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SERVICE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LAPLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-868-2251
Mailing Address - Street 1:51 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VAN BUREN
Mailing Address - State:ME
Mailing Address - Zip Code:04785-1027
Mailing Address - Country:US
Mailing Address - Phone:207-868-2251
Mailing Address - Fax:
Practice Address - Street 1:51 MAIN ST
Practice Address - Street 2:
Practice Address - City:VAN BUREN
Practice Address - State:ME
Practice Address - Zip Code:04785-1027
Practice Address - Country:US
Practice Address - Phone:207-868-2251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME7203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME704547Medicare ID - Type UnspecifiedMEDICARE