Provider Demographics
NPI:1982652715
Name:CITY OF CARIBOU
Entity Type:Organization
Organization Name:CITY OF CARIBOU
Other - Org Name:CARIBOU FIRE & AMBULANCE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SUSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-493-4215
Mailing Address - Street 1:25 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736-2710
Mailing Address - Country:US
Mailing Address - Phone:207-493-3324
Mailing Address - Fax:207-493-4207
Practice Address - Street 1:121 HIGH ST
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-2710
Practice Address - Country:US
Practice Address - Phone:800-488-4351
Practice Address - Fax:978-356-2721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
ME1353416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME007310OtherANTHEM B/C B/S
ME=========OtherUSAA INS. CO.
ME=========OtherWAUSAU INSURANCE
ME=========OtherGUARANTEE TRUST LIFE INS.
ME=========OtherIRON WORKERS LOCAL 15
ME=========OtherMACHIGONNE BENEFIT OF ME.
ME007310OtherANTHEM B/C B/S
ME=========OtherCIGNA INS. COMPANY
ME=========OtherUNITED HEALTHCARE CLAIM
ME=========OtherGE LIFE & ANUITTY
ME=========OtherMAILHANDLERS BENEFIT PLAN
ME=========OtherDEFINITY HEALTH INS. CO.
ME=========OtherMONUMENTAL LIFE INS. CO.
ME=========OtherGUARDIAN LIFE INS. CO.
ME=========OtherWPS TRICARE FOR LIFE
ME=========OtherAETNA US HEALTHCARE
ME=========OtherNAT'L ASSOC. LETTER CARRI
ME=========OtherNAT'L ASSOC. LETTER CARRI