Provider Demographics
NPI:1720157225
Name:TOWN OF GORHAM
Entity Type:Organization
Organization Name:TOWN OF GORHAM
Other - Org Name:GORHAM EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUTIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-466-2549
Mailing Address - Street 1:347 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GORHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03581-1117
Mailing Address - Country:US
Mailing Address - Phone:603-466-5611
Mailing Address - Fax:603-466-3120
Practice Address - Street 1:347 MAIN ST
Practice Address - Street 2:
Practice Address - City:GORHAM
Practice Address - State:NH
Practice Address - Zip Code:03581
Practice Address - Country:US
Practice Address - Phone:603-466-5611
Practice Address - Fax:603-466-3120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00423416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH441590545OtherRAILROAD MEDICARE
NH3078044Medicaid
NH1720157225OtherALL OTHERS
NHNH6323Medicare PIN