Provider Demographics
NPI:1992736755
Name:TRI-TOWNS AMBULANCE & RESCUE SERVICE INC
Entity type:Organization
Organization Name:TRI-TOWNS AMBULANCE & RESCUE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING AGENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-479-4790
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-0278
Mailing Address - Country:US
Mailing Address - Phone:410-479-4790
Mailing Address - Fax:410-479-4793
Practice Address - Street 1:59 MAIN ST
Practice Address - Street 2:
Practice Address - City:WESTERNPORT
Practice Address - State:MD
Practice Address - Zip Code:21562-1420
Practice Address - Country:US
Practice Address - Phone:410-479-4790
Practice Address - Fax:410-479-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9000024000Medicaid
MD142728800Medicaid
044QMedicare PIN
MD142728800Medicaid