# BOONSBORO AMBULANCE AND RESCUE SERVICE INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063442739
- **Authorized official:** MS. MARY J BLICKENSTAFF PARAMEDIC (PRESIDENT)
- **Authorized official phone:** (301) 432-6979

## Contact information

- **Practice address:** 7619 OLD NATIONAL PIKE, BOONSBORO, MD 21713-2003
- **Practice address phone:** (301) 432-6979
- **Practice address fax:** (301) 432-2265
- **Mailing address:** 7619 OLD NATIONAL PIKE, PO BOX 7, BOONSBORO, MD 21713-2003
- **Mailing address phone:** (301) 432-6979
- **Mailing address fax:** (301) 432-2265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 31077804 | MD | Yes |

## Other

- **Enumeration date:** 07/05/2006
- **Last updated:** 05/15/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 466518000 | — | MD |
| 01 | — | DM13 | BLUE CROSS BLUE SHIELD | MD |
| 01 | — | S1980001 | FEDERAL BLUE CROSS | MD |