Provider Demographics
NPI:1891778197
Name:VERGENNES AREA RESCUE SQUAD INC.
Entity Type:Organization
Organization Name:VERGENNES AREA RESCUE SQUAD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LESTER
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-475-2454
Mailing Address - Street 1:106 PANTON RD
Mailing Address - Street 2:PO BOX 11
Mailing Address - City:VERGENNES
Mailing Address - State:VT
Mailing Address - Zip Code:05491-1047
Mailing Address - Country:US
Mailing Address - Phone:802-877-3683
Mailing Address - Fax:802-877-3518
Practice Address - Street 1:106 PANTON RD
Practice Address - Street 2:
Practice Address - City:VERGENNES
Practice Address - State:VT
Practice Address - Zip Code:05491-1047
Practice Address - Country:US
Practice Address - Phone:802-877-3683
Practice Address - Fax:802-877-3518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT3416L0300X341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0006439Medicaid
VT059-19841OtherBLUE CROSS
VTVT6439Medicare ID - Type Unspecified