NPIMap

Organization Active NPI

Northeast Harbor Ambulance Service, Inc.

  • Land Ambulance
  • Northeast Harbor, ME
National Provider Identifier
1669456190
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Land AmbulanceTaxonomy code 3416L0300X
License
490 Issued in ME
Legal business name
NORTHEAST HARBOR AMBULANCE SERVICE, INC.
Practice address
21 Sea Street
Northeast Harbor, ME 04662
Phone
(207) 276-5288
Fax
(207) 276-5288
NPI assigned
Nov 29, 2005
Last updated
May 12, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Authorized official

Name
Douglass S. Gray Jr.
Title
President
Phone
(207) 276-5256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 490 ME Primary

Addresses

Primary practice location

21 Sea Street
Northeast Harbor, ME 04662

Mailing address

P O Box 122
Northeast Harbor, ME 04662
Phone (207) 276-5288

Other identifiers 1

IdentifierTypeStateIssuer
168200000MedicaidME

Other names 1

  • Northeast Harbor Ambulance Service Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494547200000",
    "number": "1669456190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 122",
            "city": "NORTHEAST HARBOR",
            "state": "ME",
            "postal_code": "04662",
            "telephone_number": "207-276-5288",
            "fax_number": "207-276-5288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SEA STREET",
            "city": "NORTHEAST HARBOR",
            "state": "ME",
            "postal_code": "04662",
            "telephone_number": "207-276-5288",
            "fax_number": "207-276-5288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST HARBOR AMBULANCE SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2017-05-12",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "DOUGLASS",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-276-5256",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ME",
            "license": "490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168200000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northeast Harbor Ambulance Service",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Northeast Harbor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 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.