Provider Demographics
NPI:1740263185
Name:SAINT MICHAELS COLLEGE FIRE AND RESCUE INC
Entity type:Organization
Organization Name:SAINT MICHAELS COLLEGE FIRE AND RESCUE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:SOONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-654-2374
Mailing Address - Street 1:SMC BOX 280
Mailing Address - Street 2:1 WINOOSKI PARK
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05439-0001
Mailing Address - Country:US
Mailing Address - Phone:802-654-2374
Mailing Address - Fax:802-654-2711
Practice Address - Street 1:230 COLLEGE PKWY
Practice Address - Street 2:
Practice Address - City:COLCHESTER
Practice Address - State:VT
Practice Address - Zip Code:05446-3050
Practice Address - Country:US
Practice Address - Phone:802-654-2374
Practice Address - Fax:802-654-2711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT03123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT6453Medicaid
AM0198Medicare ID - Type Unspecified