Provider Demographics
NPI:1316575426
Name:CITY OF WATERVILLE
Entity Type:Organization
Organization Name:CITY OF WATERVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:J
Authorized Official - Last Name:ESLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-680-4735
Mailing Address - Street 1:7 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6101
Mailing Address - Country:US
Mailing Address - Phone:207-680-4735
Mailing Address - Fax:
Practice Address - Street 1:7 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6101
Practice Address - Country:US
Practice Address - Phone:207-680-4735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport