Provider Demographics
NPI:1124158787
Name:CITY OF ROCKLAND
Entity type:Organization
Organization Name:CITY OF ROCKLAND
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:WHYTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-594-0318
Mailing Address - Street 1:270 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:ROCKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04841-5305
Mailing Address - Country:US
Mailing Address - Phone:207-593-0638
Mailing Address - Fax:
Practice Address - Street 1:118 PARK ST
Practice Address - Street 2:
Practice Address - City:ROCKLAND
Practice Address - State:ME
Practice Address - Zip Code:04841-2842
Practice Address - Country:US
Practice Address - Phone:800-964-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
ME5803416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME136050000Medicaid