Provider Demographics
NPI:1174034318
Name:TOWN OF LEVANT
Entity Type:Organization
Organization Name:TOWN OF LEVANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:STROUT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-884-8457
Mailing Address - Street 1:691 TOWNHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LEVANT
Mailing Address - State:ME
Mailing Address - Zip Code:04456-4312
Mailing Address - Country:US
Mailing Address - Phone:207-884-8457
Mailing Address - Fax:
Practice Address - Street 1:3917 UNION ST.
Practice Address - Street 2:
Practice Address - City:LEVANT
Practice Address - State:ME
Practice Address - Zip Code:04456
Practice Address - Country:US
Practice Address - Phone:207-884-8457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2024-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME09203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME=========Medicaid