Provider Demographics
NPI:1730125824
Name:SACOPEE RESCUE UNIT INC
Entity Type:Organization
Organization Name:SACOPEE RESCUE UNIT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESCUE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:LORIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ELGERLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-625-3088
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-1810
Mailing Address - Country:US
Mailing Address - Phone:207-892-0020
Mailing Address - Fax:207-893-0583
Practice Address - Street 1:1 ALLARD CIRCLE
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:ME
Practice Address - Zip Code:04041-9999
Practice Address - Country:US
Practice Address - Phone:207-625-3088
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME6003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME040684OtherBLUE CROSS
ME590014055OtherRAILROAD MEDICARE
ME107860000Medicaid
MEAM0099Medicare ID - Type Unspecified