Organization
TOWN OF MILTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY T GENTILE (AUTHORIZED AGENT)
(860) 257-9201
Entity
Organization
Contact information
Practice address
47 BOMBARDIER RD, MILTON, VT 05468-3205
(802) 891-8090
(802) 893-4556
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(860) 257-9201
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
0309
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0AM0182
—
VT
01
—
P00115232
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
12/06/2010
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