1144203852 NPI number — ESSEX RESCUE INC

Table of content: (NPI 1144203852)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144203852 NPI number — ESSEX RESCUE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESSEX RESCUE INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144203852
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 EDUCATIONAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ESSEX JUNCTION
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05452-3172
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-488-4351
Provider Business Mailing Address Fax Number:
978-356-2721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 EDUCATIONAL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESSEX JUNCTION
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05452-3172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-878-4859
Provider Business Practice Location Address Fax Number:
802-878-1246
Provider Enumeration Date:
11/28/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BALLARD
Authorized Official First Name:
COLLEEN
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
802-878-4859

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X , with the licence number: 0304 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)