Provider Demographics
NPI:1841233111
Name:NEWPORT AMBULANCE SERVICE INC.
Entity Type:Organization
Organization Name:NEWPORT AMBULANCE SERVICE INC.
Other - Org Name:NORTHERN EMERGENCY MEDICAL SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARADIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-334-2023
Mailing Address - Street 1:PO BOX 911
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:VT
Mailing Address - Zip Code:05855-0911
Mailing Address - Country:US
Mailing Address - Phone:802-334-2023
Mailing Address - Fax:802-334-7536
Practice Address - Street 1:830 UNION ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:VT
Practice Address - Zip Code:05855-5523
Practice Address - Country:US
Practice Address - Phone:802-334-2023
Practice Address - Fax:802-334-7536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT02073416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VTNEWP6389Medicaid
VT0006389OtherMAIN PROVIDER NUMBER
VTVT6389Medicare ID - Type UnspecifiedPROVIDER NUMBER