Organization
KENNEBUNKPORT EMERGENCY MEDICAL SER INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAWN P MCPHERSON (BILLING MANAGER)
(207) 892-0020
Entity
Organization
Contact information
Practice address
172 MAIN ST, KENNEBUNKPORT, ME 04046-6911
(207) 967-9704
(207) 967-2496
Mailing address
P O BOX 1810, WINDHAM, ME 04062
(207) 892-0020
(207) 893-0583
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
VIN94187 VEHICLE 987
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109920000
—
ME
Enumeration date
04/26/2006
Last updated
03/14/2013
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