Provider Demographics
NPI:1427513720
Name:TOWN OF SULLIVAN
Entity type:Organization
Organization Name:TOWN OF SULLIVAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASST. EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OGDEN
Authorized Official - Suffix:
Authorized Official - Credentials:NRAEMT
Authorized Official - Phone:207-422-3220
Mailing Address - Street 1:1888 US HWY 1
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:ME
Mailing Address - Zip Code:04664-3115
Mailing Address - Country:US
Mailing Address - Phone:207-422-6282
Mailing Address - Fax:
Practice Address - Street 1:1888 US HWY 1
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:ME
Practice Address - Zip Code:04664-3115
Practice Address - Country:US
Practice Address - Phone:207-422-6282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport