# TOWN OF KENNEBUNK

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

## Provider details

- **NPI number:** 1780667600
- **Authorized official:** JUSTIN COOPER (CHIEF)
- **Authorized official phone:** (207) 604-1358

## Contact information

- **Practice address:** 1 SUMMER ST, KENNEBUNK, ME 04043-6641
- **Practice address phone:** (207) 985-2102
- **Mailing address:** PO BOX 1810, WINDHAM, ME 04062-1810
- **Mailing address phone:** (207) 892-0020
- **Mailing address fax:** (207) 893-0583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | 0390 | ME | Yes |

## Other

- **Enumeration date:** 11/23/2005
- **Last updated:** 08/30/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 014819 | ANTHEM BLUE CROSS | — |
| 05 | — | 136750000 | — | ME |
| 01 | — | 590008496 | RR MEDICARE | — |