Organization
TOWN OF KENNEBUNK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN COOPER (CHIEF)
(207) 604-1358
Entity
Organization
Contact information
Practice address
1 SUMMER ST, KENNEBUNK, ME 04043-6641
(207) 985-2102
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
0390
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
014819
ANTHEM BLUE CROSS
—
05
—
136750000
—
ME
01
—
590008496
RR MEDICARE
—
Enumeration date
11/23/2005
Last updated
08/30/2022
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