Provider Demographics
NPI:1336251529
Name:LOWER SOMERSET AMBULANCE AND RESCUE
Entity Type:Organization
Organization Name:LOWER SOMERSET AMBULANCE AND RESCUE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:RETTIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-968-2000
Mailing Address - Street 1:PO BOX 406
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-0406
Mailing Address - Country:US
Mailing Address - Phone:410-968-2000
Mailing Address - Fax:410-968-0416
Practice Address - Street 1:2 MILL LN
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-0406
Practice Address - Country:US
Practice Address - Phone:410-968-2000
Practice Address - Fax:410-968-0416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDY677OtherCAREFIRST BLUE CROSS/BLUE SHIELD
MD840641300Medicaid
MD261844Medicare PIN