Provider Demographics
NPI:1093882961
Name:TOWN OF HOULTON
Entity Type:Organization
Organization Name:TOWN OF HOULTON
Other - Org Name:HOULTON AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:CONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-532-1320
Mailing Address - Street 1:21 WATER ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-2104
Mailing Address - Country:US
Mailing Address - Phone:207-532-1320
Mailing Address - Fax:207-532-1323
Practice Address - Street 1:99 MILITARY ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-2451
Practice Address - Country:US
Practice Address - Phone:207-532-1320
Practice Address - Fax:207-532-1323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3603416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME006770OtherANTHEM PROVIDER ID
ME136680000Medicaid
ME441590120OtherRAILROAD MEDICARE ID