Derby Line Ambulance

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

0204 Issued in VT

Legal business name

DERBY LINE AMBULANCE

Practice address

67 Beech St
Derby Line, VT 05830-9302

Phone

(802) 334-2023

NPI assigned

Jun 17, 2006

Last updated

Aug 29, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael Paradis

Title

Ceo

Phone

(802) 334-2023

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503964800000",
    "number": "1265477012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058550911",
            "telephone_number": "802-334-2023",
            "fax_number": "802-334-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 BEECH ST",
            "city": "DERBY LINE",
            "state": "VT",
            "postal_code": "058309302",
            "telephone_number": "802-334-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERBY LINE AMBULANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2017-08-29",
        "status": "A",
        "authorized_official_last_name": "PARADIS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "802-334-2023"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "VT",
            "license": "0204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIN PROVIDER",
            "identifier": "0006385",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "DERB6385",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Land Ambulance in Derby Line, VT
• Providers in Derby Line, VT by specialty
• Land Ambulance in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.