Provider Demographics
NPI:1285755843
Name:TOWN OF MILLINOCKET
Entity type:Organization
Organization Name:TOWN OF MILLINOCKET
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWN MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMIESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-723-7000
Mailing Address - Street 1:197 PENOBSCOT AVE
Mailing Address - Street 2:
Mailing Address - City:MILLINOCKET
Mailing Address - State:ME
Mailing Address - Zip Code:04462
Mailing Address - Country:US
Mailing Address - Phone:207-447-4126
Mailing Address - Fax:207-723-7022
Practice Address - Street 1:197 PENOBSCOT AVE
Practice Address - Street 2:
Practice Address - City:MILLINOCKET
Practice Address - State:ME
Practice Address - Zip Code:04462
Practice Address - Country:US
Practice Address - Phone:207-723-7026
Practice Address - Fax:207-723-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME004648OtherANTHEM
ME136870000Medicaid
ME0020442323Medicare ID - Type Unspecified
701416Medicare UPIN