Provider Demographics
NPI:1750351607
Name:SOUTH BERWICK EMERGENCY AMBULANCE & RESCUE SERVICE INC
Entity type:Organization
Organization Name:SOUTH BERWICK EMERGENCY AMBULANCE & RESCUE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-384-2300
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:71 NORTON ST
Practice Address - Street 2:
Practice Address - City:SOUTH BERWICK
Practice Address - State:ME
Practice Address - Zip Code:03908-1124
Practice Address - Country:US
Practice Address - Phone:207-384-2300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0202341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME167750000Medicaid
656072OtherHARVARD PILGRIM
590009984OtherRR MEDICARE
ME71Z011807ME01OtherBLUE CROSS BLUE SHIELD
NH30010505Medicaid
71Y002172ME01OtherANTHEM BLUECROSS
ME011807OtherBLUE CROSS BLUE SHIELD