Provider Demographics
NPI:1295884112
Name:DALTON AMBULANCE AND RESCUE INC
Entity type:Organization
Organization Name:DALTON AMBULANCE AND RESCUE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-684-6127
Mailing Address - Street 1:20 FLANSBURG AVE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-1409
Mailing Address - Country:US
Mailing Address - Phone:413-684-6127
Mailing Address - Fax:413-684-6120
Practice Address - Street 1:20 FLANSBURG AVE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:MA
Practice Address - Zip Code:01226-1409
Practice Address - Country:US
Practice Address - Phone:413-684-0500
Practice Address - Fax:413-684-6120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3355341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000000027879OtherBOSTON MEDICAL PROV NUM
MA1171261Medicaid
MA000000027879OtherBOSTON MEDICAL PROV NUM