Town of Jackman

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1043 Issued in ME

Legal business name

TOWN OF JACKMAN

Doing business as

Jackman-Moose River Fire & Rescue Department

Practice address

376 Main St
Jackman, ME 04945-9999

Phone

(207) 892-0020

NPI assigned

Sep 18, 2017

Last updated

Sep 18, 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

Mr. William Jarvis

Title

Chief

Phone

(207) 668-9516

Specialties & licenses 1

Addresses

Other names 1

• Jackman-Moose River Fire & Rescue Department Doing business as

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505692800000",
    "number": "1407375777",
    "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": "376 MAIN ST",
            "city": "JACKMAN",
            "state": "ME",
            "postal_code": "049459999",
            "telephone_number": "207-892-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF JACKMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A",
        "authorized_official_last_name": "JARVIS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "207-668-9516",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ME",
            "license": "1043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jackman-Moose River Fire & Rescue Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Country Associates, Inc (Northland Living Center)
• Penobscot Community Health Center (Forest Hills School)
• Penobscot Community Health Center (Jackman Urgent Care Center)
• Penobscot Community Health Center (Jackman Community Health Center)
• Julia B St John, LCSW

• Land Ambulance in Jackman, ME
• Providers in Jackman, ME by specialty
• Land Ambulance in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2017; 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.