Pownal Rescue Squad Incorporated
Organization Active NPI Ambulance · Pownal, VT
NPI 1174513634 · NPPES record last updated Aug 30, 2024
Key facts
- NPI
- 1174513634
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 1207 (VT)
- Legal business name
- POWNAL RESCUE SQUAD INCORPORATED
- Practice address
- 54 Ladd Road
Pownal, VT 05261 - Phone
- (802) 823-5200
- NPI assigned
- Oct 26, 2005
- Organization subpart
- No
Authorized official
- Name
- Leo J Haggerty
- Title
- Chief
- Phone
- (802) 823-5200
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070913000336 | VT | Part B Supplier - Ambulance Service Supplier | 1759475379 | Practice locations: Pownal, VT |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 1207 | VT | Yes |
Addresses
Primary practice location
54 Ladd Road
Pownal, VT 05261
Mailing address
PO Box 207
Allentown, PA 18105-0207
Phone (800) 473-2278
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590009360 | Other | RAILROAD MEDICARE | |
| 0006499 | Medicaid | VT |
Other providers in Pownal, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.