Provider Demographics
NPI:1285635326
Name:ACTON AMBULANCE ASSOCIATION
Entity Type:Organization
Organization Name:ACTON AMBULANCE ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DEB
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-636-4178
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:1725 ROUTE 109
Practice Address - Street 2:
Practice Address - City:ACTON
Practice Address - State:ME
Practice Address - Zip Code:04001-5218
Practice Address - Country:US
Practice Address - Phone:207-636-5005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0033416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME112220000Medicaid
ME014815OtherBCBS
ME703404Medicare ID - Type Unspecified