Organization
WHITE RIVER VALLEY AMBULANCE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA A EDWARDS (OPERATIONS SUPERVISOR)
(802) 234-6800
Entity
Organization
Contact information
Practice address
3190 PLEASANT STREET, BETHEL, VT 05032
(802) 234-6800
(802) 234-5629
Mailing address
3190 PLEASANT STREET, BETHEL, VT 05032
(802) 234-6800
(802) 234-6529
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0804
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006449
—
VT
01
—
590092508
MEDICARE RAIL ROAD
VT
05
—
NH MEDICAID
—
NH
01
—
VT BLUE CROSS BLUE
6449
VT
Enumeration date
11/30/2006
Last updated
11/14/2011
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