Provider Demographics
NPI:1881715233
Name:TOWN OF ISLESBORO
Entity type:Organization
Organization Name:TOWN OF ISLESBORO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLERK
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-734-2253
Mailing Address - Street 1:PO BOX 76
Mailing Address - Street 2:
Mailing Address - City:ISLESBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04848-0076
Mailing Address - Country:US
Mailing Address - Phone:207-734-2253
Mailing Address - Fax:
Practice Address - Street 1:150 MAIN ROAD
Practice Address - Street 2:
Practice Address - City:ISLESBORO
Practice Address - State:ME
Practice Address - Zip Code:04848
Practice Address - Country:US
Practice Address - Phone:207-734-2253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-03
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME3703416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME136700200Medicaid
ME705926Medicare ID - Type UnspecifiedMEDICARE