Provider Demographics
NPI:1962495051
Name:TOWN OF SCARBOROUGH
Entity Type:Organization
Organization Name:TOWN OF SCARBOROUGH
Other - Org Name:SCARBOROUGH FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:KINDELAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-730-4201
Mailing Address - Street 1:PO BOX 360
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04070-0360
Mailing Address - Country:US
Mailing Address - Phone:207-730-4003
Mailing Address - Fax:207-730-4004
Practice Address - Street 1:259 US ROUTE 1
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-9525
Practice Address - Country:US
Practice Address - Phone:207-730-4003
Practice Address - Fax:207-730-4004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME615341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME590132238OtherPALMETTO GBA-RR MC
ME137170000Medicaid
ME001185OtherANTHEM
ME590132238OtherPALMETTO GBA-RR MC