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Organization

DERBY LINE AMBULANCE

Active
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Organization

DERBY LINE AMBULANCE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL PARADIS (CEO)
(802) 334-2023
Entity
Organization

Contact information

Practice address
67 BEECH ST, DERBY LINE, VT 05830-9302
(802) 334-2023
Mailing address
PO BOX 911, NEWPORT, VT 05855-0911
(802) 334-2023
(802) 334-7536

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
0204
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0006385
MAIN PROVIDER
VT
05
—
DERB6385
—
VT
Enumeration date
06/17/2006
Last updated
08/29/2017
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