Provider Demographics
NPI:1083696157
Name:TOWN OF CHESTER
Entity Type:Organization
Organization Name:TOWN OF CHESTER
Other - Org Name:CHESTER AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:TOWN MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-875-2173
Mailing Address - Street 1:556 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05143-9350
Mailing Address - Country:US
Mailing Address - Phone:802-875-2173
Mailing Address - Fax:802-875-2237
Practice Address - Street 1:556 ELM ST
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:VT
Practice Address - Zip Code:05143-9350
Practice Address - Country:US
Practice Address - Phone:802-875-2173
Practice Address - Fax:802-875-2237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT11023416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006422Medicaid
VT6422OtherVT BLUE CROSS BLUE SHIELD
VTVT6422Medicare ID - Type Unspecified