# CITY OF PORTLAND

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- **Entity:** Organization
- **Status:** Active
- **Other names:** City of Portland Medcu
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134185648
- **Authorized official:** CHRISTOPHER H GOODALL (ASSISTANT FIRE CHIEF)
- **Authorized official phone:** (207) 874-8409

## Contact information

- **Practice address:** 380 CONGRESS ST, PORTLAND, ME 04101-3513
- **Practice address phone:** (207) 874-8400
- **Practice address fax:** (207) 874-8410
- **Mailing address:** PO BOX 16020, LEWISTON, ME 04243-9597
- **Mailing address phone:** (207) 874-8400
- **Mailing address fax:** (207) 874-8410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 0546 | ME | Yes |
| 3416L0300X | Land Ambulance | 546 | ME | — |

## Other

- **Enumeration date:** 04/24/2006
- **Last updated:** 04/27/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1001171 | BLUE CROSS | ME |
| 05 | — | 136040100 | — | ME |
| 01 | — | 441590199 | RAILROAD MEDICARE | ME |