Provider Demographics
NPI:1477762938
Name:WALLINGFORD RESCUE, INC.
Entity Type:Organization
Organization Name:WALLINGFORD RESCUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:REYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-446-2138
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05773-0246
Mailing Address - Country:US
Mailing Address - Phone:802-446-2138
Mailing Address - Fax:802-446-2138
Practice Address - Street 1:30 RAILROAD STREET
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:VT
Practice Address - Zip Code:05773-0246
Practice Address - Country:US
Practice Address - Phone:802-446-2138
Practice Address - Fax:802-446-2138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1011341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT=========Medicare UPIN
VTVT6479Medicare ID - Type Unspecified