Memorial Ambulance Corps. Isle Au Haut - Stonington - Deer Isle

Primary specialty

AmbulanceTaxonomy code 341600000X

License

460 Issued in ME

Legal business name

MEMORIAL AMBULANCE CORPS. ISLE AU HAUT - STONINGTON - DEER ISLE

Doing business as

Memorial Ambulance Corps.

Practice address

77 Sunshine Rd
Deer Isle, ME 04627

Phone

(207) 348-5686

Fax

(207) 348-5692

NPI assigned

Dec 1, 2005

Last updated

Nov 7, 2012By 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

Walter T. Reed, EMT-I

Title

Director - Memorial Ambulance Corps

Phone

(207) 348-5686

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Memorial Ambulance Corps. 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": "1133395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1720062987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 387",
            "city": "DEER ISLE",
            "state": "ME",
            "postal_code": "04627",
            "telephone_number": "207-348-5686",
            "fax_number": "207-348-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 SUNSHINE RD",
            "city": "DEER ISLE",
            "state": "ME",
            "postal_code": "04627",
            "telephone_number": "207-348-5686",
            "fax_number": "207-348-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL AMBULANCE CORPS. ISLE AU HAUT - STONINGTON - DEER ISLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-01",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "WALTER",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "DIRECTOR - MEMORIAL AMBULANCE CORPS",
        "authorized_official_telephone_number": "207-348-5686",
        "authorized_official_credential": "EMT-I"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "ME",
            "license": "460",
            "primary": true
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "ME",
            "license": "460",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104070000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Memorial Ambulance Corps.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erin Hutchins, MSPT
• Lori Marie Ingram, COTAL
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• Caitlin Johnston, PTA
• Laurie Lynn Marcel, COTA/L
• Hollan S Oliver, DPT
• Alison Allen Richards, PTA
• Tanya Lee Ruzyckij, OCCUPATIONAL THERAPY
• Elinor A Spencer, OTL
• Robin Vanbuskirk

• Ambulance in Deer Isle, ME
• Providers in Deer Isle, ME by specialty
• Ambulance in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.