1497864904 NPI number — UPPER VALLEY AMBULANCE, INC

Table of content: (NPI 1497864904)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497864904 NPI number — UPPER VALLEY AMBULANCE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UPPER VALLEY AMBULANCE, 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:
1497864904
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 TURCOTTE MEMORIAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROWLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01969-1706
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:
5445 LAKE MOREY ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRLEE
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05045-0037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-333-4043
Provider Business Practice Location Address Fax Number:
802-333-4234
Provider Enumeration Date:
08/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHAPMAN
Authorized Official First Name:
EVA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
802-333-4043

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: 0919 , 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)