Provider Demographics
NPI:1922052745
Name:TOWN OF CAPE ELIZABETH
Entity Type:Organization
Organization Name:TOWN OF CAPE ELIZABETH
Other - Org Name:CAPE ELIZABETH RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE RESCUE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:GLEESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-767-7417
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-1810
Mailing Address - Country:US
Mailing Address - Phone:207-892-0020
Mailing Address - Fax:207-893-0583
Practice Address - Street 1:2 JORDAN WAY
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2443
Practice Address - Country:US
Practice Address - Phone:207-767-7417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1303416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME039397OtherBLUE CROSS
ME590014366OtherRAILROAD MEDICARE
ME136270100Medicaid
ME136270100Medicaid