1649207796 NPI number — MISSISQUOI VALLEY AMBULANCE SERVICE, INC.

Table of content: (NPI 1649207796)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649207796 NPI number — MISSISQUOI VALLEY AMBULANCE SERVICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MISSISQUOI VALLEY AMBULANCE SERVICE, 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:
1649207796
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 153
Provider Second Line Business Mailing Address:
C/O NEW ENGLAND AMBULANCE BILLING, INC.
Provider Business Mailing Address City Name:
VERGENNES
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05491-0153
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-877-2429
Provider Business Mailing Address Fax Number:
802-877-2292

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1375 CROSS RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAY
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-988-1098
Provider Business Practice Location Address Fax Number:
802-877-2429
Provider Enumeration Date:
06/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MESSINGER
Authorized Official First Name:
ANNE
Authorized Official Middle Name:
E
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
802-877-2429

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0206 , 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)

  • Identifier: 0006460 . This is a "MAIN PROVIDER" identifier , issued by the state of ( VT ) . This identifiers is of the category "OTHER".
  • Identifier: 0006460 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




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