Provider Demographics
NPI:1588653380
Name:CITY OF DOVER
Entity Type:Organization
Organization Name:CITY OF DOVER
Other - Org Name:DOVER FIRE & RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIVISION CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCSHANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-516-6156
Mailing Address - Street 1:288 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-4198
Mailing Address - Country:US
Mailing Address - Phone:603-516-6151
Mailing Address - Fax:603-516-6146
Practice Address - Street 1:262 6TH ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-2301
Practice Address - Country:US
Practice Address - Phone:603-516-6151
Practice Address - Fax:603-516-6146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2018-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME143640000Medicaid
7106279Y0NH01OtherANTHEM BLUE CROSS
NH3078801Medicaid
NH7106279Y0NH01OtherMEDICOMP
701825OtherHARVARD PILGRIM
802696OtherTUFTS HEALTH PLAN
802696OtherTUFTS HEALTH PLAN
7106279Y0NH01OtherANTHEM BLUE CROSS