# MERIDIAN MOBILE HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Capital Ambulance
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568596401
- **Authorized official:** JOSEPH C KELLNER (DIRECTOR OF GROUND TRANSPORT)
- **Authorized official phone:** (207) 973-6700

## Contact information

- **Practice address:** 931 UNION STREET, BANGOR, ME 04401
- **Practice address phone:** (207) 973-4700
- **Practice address fax:** (207) 973-4713
- **Mailing address:** PO BOX 940, BANGOR, ME 04402-0940
- **Mailing address phone:** (207) 973-4700
- **Mailing address fax:** (207) 973-4713

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 133 | ME | Yes |

## Other

- **Enumeration date:** 03/15/2007
- **Last updated:** 12/17/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 025094 | ANTHEM | — |
| 05 | — | 130900000 | — | ME |