Provider Demographics
NPI:1770522658
Name:TOWN OF EAST MILLINOCKET
Entity type:Organization
Organization Name:TOWN OF EAST MILLINOCKET
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCADAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-746-3562
Mailing Address - Street 1:53 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST MILLINOCKET
Mailing Address - State:ME
Mailing Address - Zip Code:04430-1126
Mailing Address - Country:US
Mailing Address - Phone:207-746-3562
Mailing Address - Fax:207-746-3564
Practice Address - Street 1:125 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST MILLINOCKET
Practice Address - State:ME
Practice Address - Zip Code:04430-1047
Practice Address - Country:US
Practice Address - Phone:207-746-3562
Practice Address - Fax:207-746-3564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-06
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME136480000Medicaid