Provider Demographics
NPI:1760793541
Name:TOWN OF WILLISTON
Entity Type:Organization
Organization Name:TOWN OF WILLISTON
Other - Org Name:WILLISTON FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:N
Authorized Official - Last Name:MORTON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:802-878-5622
Mailing Address - Street 1:645 TALCOTT RD
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-2079
Mailing Address - Country:US
Mailing Address - Phone:802-878-5622
Mailing Address - Fax:802-878-0973
Practice Address - Street 1:645 TALCOTT RD
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-2079
Practice Address - Country:US
Practice Address - Phone:802-878-5622
Practice Address - Fax:802-878-0973
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0331341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance