NPIMap

Organization Active NPI

City of Gardiner

Doing business as Gardiner Ambulance Service

  • Land Ambulance
  • Gardiner, ME
National Provider Identifier
1023184140
Registry record updated Dec 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
282 Issued in ME
Legal business name
CITY OF GARDINER
Doing business as
Gardiner Ambulance Service
Practice address
6 Church St
Gardiner, ME 04345-2170
Phone
(207) 582-5150
Fax
(207) 582-5150
NPI assigned
Nov 28, 2006
Last updated
Dec 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Alfred Nelson
Title
Chief
Phone
(207) 582-5150

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 282 ME Primary

Addresses

Primary practice location

6 Church St
Gardiner, ME 04345-2170

Mailing address

PO Box 1810
Windham, ME 04062-1810
Phone (207) 892-0020

Other identifiers 2

IdentifierTypeStateIssuer
136020000MedicaidME
136020080MedicaidME

Other names 1

  • Gardiner Ambulance Service Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070730000017 ME Part B Supplier - Ambulance Service Supplier 3072614411 Practice locations: Gardiner, ME

National Provider Directory

National Provider Directory

Locations

6 Church St
Gardiner, ME 04345
Phone (207) 582-4532

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482105600000",
    "number": "1023184140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1810",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040621810",
            "telephone_number": "207-892-0020",
            "fax_number": "207-893-0583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CHURCH ST",
            "city": "GARDINER",
            "state": "ME",
            "postal_code": "043452170",
            "telephone_number": "207-582-5150",
            "fax_number": "207-582-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF GARDINER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2016-12-19",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "207-582-5150",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ME",
            "license": "282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136020000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "136020080",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gardiner Ambulance Service",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gardiner, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.