Provider Demographics
NPI:1215979653
Name:TOWN OF RICHFORD
Entity type:Organization
Organization Name:TOWN OF RICHFORD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWN CLERK/TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KILEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEUSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-848-7751
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:RICHFORD AMBULANCE SERVICE
Mailing Address - City:RICHFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05476
Mailing Address - Country:US
Mailing Address - Phone:802-848-7751
Mailing Address - Fax:802-848-7752
Practice Address - Street 1:48 MAIN ST
Practice Address - Street 2:RICHFORD AMBULANCE SERVICE
Practice Address - City:RICHFORD
Practice Address - State:VT
Practice Address - Zip Code:05476
Practice Address - Country:US
Practice Address - Phone:802-848-7751
Practice Address - Fax:802-848-7752
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF RICHFORD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-11
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006428Medicaid
VT590092212OtherMEDICARE RAILROAD
VT6428OtherBLUE CROSS BLUE SHIRLD
VT6428OtherBLUE CROSS BLUE SHIRLD
VT0006428Medicaid