Organization
CITY OF SOUTH PORTLAND
Active
Other names
South Portland Fire & Rescue
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL E CARROLL EMT P (EMS COORDINATOR)
(207) 799-3314
Entity
Organization
Contact information
Practice address
684 BROADWAY, SOUTH PORTLAND, ME 04106-4407
(207) 797-3314
Mailing address
PO BOX 1810, WINDHAM, ME 04062-1810
(207) 892-0020
(207) 893-0583
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
655
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001173
BLUE CROSS
ME
05
—
136070000
—
ME
01
—
590000162
RAILROAD MEDICARE
ME
Enumeration date
07/19/2006
Last updated
10/05/2011
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