Provider Demographics
NPI:1861474272
Name:CALEDONIA-ESSEX AREA AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:CALEDONIA-ESSEX AREA AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:REXFORD
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:802-748-7544
Mailing Address - Street 1:PO BOX 8648
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:VT
Mailing Address - Zip Code:05451-8648
Mailing Address - Country:US
Mailing Address - Phone:877-398-1519
Mailing Address - Fax:802-871-5352
Practice Address - Street 1:1453 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:ST. JOHNSBURY
Practice Address - State:VT
Practice Address - Zip Code:05819
Practice Address - Country:US
Practice Address - Phone:802-748-7544
Practice Address - Fax:802-748-7545
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-19
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT05093416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT6480OtherBLUE CROSS/BLUE SHIELD
VT590002498OtherRAILROAD MEDICARE
VT0006480Medicaid
NH3078832Medicaid
VT6480OtherBLUE CROSS/BLUE SHIELD