Provider Demographics
NPI:1477577039
Name:TOWN OF ISLAND FALLS
Entity Type:Organization
Organization Name:TOWN OF ISLAND FALLS
Other - Org Name:ISLAND FALLS AMBULANCE SERVICE
Other - Org Type:Other Name
Authorized Official - Title/Position:TOWN CLERK
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCNALLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-463-2246
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:ISLAND FALLS
Mailing Address - State:ME
Mailing Address - Zip Code:04747-0100
Mailing Address - Country:US
Mailing Address - Phone:207-463-2246
Mailing Address - Fax:207-463-2550
Practice Address - Street 1:61 HOULTON STREET
Practice Address - Street 2:
Practice Address - City:ISLAND FALLS
Practice Address - State:ME
Practice Address - Zip Code:04747
Practice Address - Country:US
Practice Address - Phone:207-463-2246
Practice Address - Fax:207-463-2550
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF ISLAND FALLS MAINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-27
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME388146L00000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
No3416L0300XTransportation ServicesAmbulanceLand TransportGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME136690000Medicaid
ME136690000Medicaid
708941Medicare PIN