Organization
POULTNEY RESCUE SQUAD INC
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
409 VT ROUTE 30 S, POULTNEY, VT 05764-9015
(802) 287-5575
(802) 287-2207
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
1009
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006472
—
VT
01
—
590008698
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
05/05/2008
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