Provider Demographics
NPI:1093906083
Name:FITCHBURG EMERGENCY MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:FITCHBURG EMERGENCY MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MELEHOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-466-8883
Mailing Address - Street 1:PO BOX 981309
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02298-1309
Mailing Address - Country:US
Mailing Address - Phone:508-799-5999
Mailing Address - Fax:508-635-9520
Practice Address - Street 1:1000 BATTLES ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1502
Practice Address - Country:US
Practice Address - Phone:978-466-8883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2019-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39983416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1719351Medicaid
VT1014600Medicaid
MA000214001Medicare PIN