Provider Demographics
NPI:1174640551
Name:TOWN OF BUCKSPORT AMBULANCE
Entity Type:Organization
Organization Name:TOWN OF BUCKSPORT AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-469-7951
Mailing Address - Street 1:P.O. BOX X
Mailing Address - Street 2:50 MAIN STREET
Mailing Address - City:BUCKSPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04416
Mailing Address - Country:US
Mailing Address - Phone:207-469-7368
Mailing Address - Fax:207-469-7369
Practice Address - Street 1:89 FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:BUCKSPORT
Practice Address - State:ME
Practice Address - Zip Code:04416
Practice Address - Country:US
Practice Address - Phone:207-469-7951
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME115146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME015064OtherANTHEM BCBS
ME701890Medicare ID - Type Unspecified