Provider Demographics
NPI:1679690374
Name:BAGADUCE AMBULANCE CORPS
Entity Type:Organization
Organization Name:BAGADUCE AMBULANCE CORPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRAWFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-469-2128
Mailing Address - Street 1:PO BOX 522
Mailing Address - Street 2:
Mailing Address - City:CASTINE
Mailing Address - State:ME
Mailing Address - Zip Code:04421-0522
Mailing Address - Country:US
Mailing Address - Phone:207-469-2128
Mailing Address - Fax:
Practice Address - Street 1:102 COURT STREET
Practice Address - Street 2:
Practice Address - City:CASTINE
Practice Address - State:ME
Practice Address - Zip Code:04421-0522
Practice Address - Country:US
Practice Address - Phone:207-469-2128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME706737MEMedicare ID - Type UnspecifiedAMBULANCE PROVIDER