Provider Demographics
NPI:1992827166
Name:HERMON VOLUNTEER RESCUE AND FIRST AID SQUAD, INC
Entity Type:Organization
Organization Name:HERMON VOLUNTEER RESCUE AND FIRST AID SQUAD, INC
Other - Org Name:HERMON VOL RESCUE SQUAD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-992-4700
Mailing Address - Street 1:PO BOX 8064
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-8064
Mailing Address - Country:US
Mailing Address - Phone:207-992-4700
Mailing Address - Fax:207-942-8213
Practice Address - Street 1:262 BILLINGS RD
Practice Address - Street 2:
Practice Address - City:HERMON
Practice Address - State:ME
Practice Address - Zip Code:04401-0535
Practice Address - Country:US
Practice Address - Phone:207-992-4700
Practice Address - Fax:207-942-8213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3503416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME790044Medicare ID - Type Unspecified