Fair Haven Volunteer Rescue Squad, Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

1004 Issued in VT

Legal business name

FAIR HAVEN VOLUNTEER RESCUE SQUAD, INC

Doing business as

Fair Haven Rescue Squad

Practice address

17 Prospect St
Fair Haven, VT 05743-1220

Phone

(802) 265-3620

Fax

(802) 265-8804

NPI assigned

Apr 13, 2006

Last updated

Oct 1, 2021By 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

Sean Galvin

Title

Manager

Phone

(802) 265-3620

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Fair Haven Rescue Squad Doing business as

Medicare fee-for-service enrollment

Enrolled in VT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633046400000",
    "number": "1508820994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 PROSPECT ST",
            "city": "FAIR HAVEN",
            "state": "VT",
            "postal_code": "057431220",
            "telephone_number": "802-265-3620",
            "fax_number": "802-265-8804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 PROSPECT ST",
            "city": "FAIR HAVEN",
            "state": "VT",
            "postal_code": "057431220",
            "telephone_number": "802-265-3620",
            "fax_number": "802-265-8804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIR HAVEN VOLUNTEER RESCUE SQUAD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A",
        "authorized_official_last_name": "GALVIN",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "802-265-3620"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "VT",
            "license": "1004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01655861",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "590006228",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fair Haven Rescue Squad",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fair Haven Rescue Squad",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Cretti, CCC-SLP, TSSLD
• Virginia Lynn Daley, LPN
• Donna P Johnson Physical Therapy PC
• Donna P Johnson Physical Therapy PC
• H & K Dental Services ,PLC (Fair Haven Dental)
• Emily J Macura, DPT
• Ryan P Mahar, PT
• Donna Plante, PT
• Dru Ann Pollinger, VMD

• Ambulance in Fair Haven, VT
• Providers in Fair Haven, VT by specialty
• Ambulance in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.