Provider Demographics
NPI:1871646968
Name:TWIN RIVERS AMBULANCE SERVICE LLC
Entity Type:Organization
Organization Name:TWIN RIVERS AMBULANCE SERVICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-744-3208
Mailing Address - Street 1:274 FOSTER POND RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:NH
Mailing Address - Zip Code:03222-6717
Mailing Address - Country:US
Mailing Address - Phone:603-744-3208
Mailing Address - Fax:
Practice Address - Street 1:274 FOSTER POND RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:NH
Practice Address - Zip Code:03222-6717
Practice Address - Country:US
Practice Address - Phone:603-744-3208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH08420P146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty