Provider Demographics
NPI:1225090236
Name:TOWN OF HARMONY
Entity Type:Organization
Organization Name:TOWN OF HARMONY
Other - Org Name:HARMONY REGIONAL AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHEIF
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHADBOURNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-777-6006
Mailing Address - Street 1:192 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-5435
Mailing Address - Country:US
Mailing Address - Phone:207-777-6006
Mailing Address - Fax:207-777-6010
Practice Address - Street 1:37 NORTH RD
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:ME
Practice Address - Zip Code:04942-7632
Practice Address - Country:US
Practice Address - Phone:207-777-6006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME324341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME136650000Medicaid
012192OtherBLUE CROSS
012192OtherBLUE CROSS
=========OtherCOMMERCIAL
P00051158Medicare ID - Type UnspecifiedRAILROAD MEDICARE