Provider Demographics
NPI:1346389087
Name:CITY OF BANGOR
Entity Type:Organization
Organization Name:CITY OF BANGOR
Other - Org Name:BANGOR FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-992-4701
Mailing Address - Street 1:289 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6403
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:289 MAIN ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6403
Practice Address - Country:US
Practice Address - Phone:207-992-4700
Practice Address - Fax:207-942-8213
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY OF BANGOR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-06
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
ME503416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME135940500Medicaid
ME135940500Medicaid