Provider Demographics
NPI:1407820665
Name:WHITINGHAM AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:WHITINGHAM AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:S
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:802-368-2900
Mailing Address - Street 1:PO BOX 963
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05342-0963
Mailing Address - Country:US
Mailing Address - Phone:802-368-2900
Mailing Address - Fax:802-368-7560
Practice Address - Street 1:2964 RT 100
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:VT
Practice Address - Zip Code:05342
Practice Address - Country:US
Practice Address - Phone:802-368-2900
Practice Address - Fax:802-368-7560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1209341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0AM0073Medicaid
VT0AM0073Medicaid