Provider Demographics
NPI:1811002702
Name:COMMUNITY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:COMMUNITY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MUNICIPLE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-228-2841
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:LUDLOW
Mailing Address - State:VT
Mailing Address - Zip Code:05149-0359
Mailing Address - Country:US
Mailing Address - Phone:802-228-2641
Mailing Address - Fax:880-222-8281
Practice Address - Street 1:19 W HILL RD
Practice Address - Street 2:
Practice Address - City:LUDLOW
Practice Address - State:VT
Practice Address - Zip Code:05149-1024
Practice Address - Country:US
Practice Address - Phone:802-228-2880
Practice Address - Fax:802-228-7996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
VT11113416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT6426OtherBCBS PROVIDER NUMBER
VT0006426Medicaid
VTVT6426Medicare ID - Type UnspecifiedPROVIDER NUMBER