CITY OF BURLINGTON VERMONT (BURLINGTON FIRE DEPARTMENT AMBULANCE) - NPI NUMBER 1306870381

Summary

Provider Name: CITY OF BURLINGTON VERMONT (BURLINGTON FIRE DEPARTMENT AMBULANCE)

NPI Number: 1306870381

Clasification: Ambulance (3416L0300X)

Specialization: Land Transport

Address:
136 S WINOOSKI AVE
BURLINGTON, VT
ZIP 05401

Phone Number: (802) 658-9423



Detailed Information

CITY OF BURLINGTON VERMONT is a land transport ambulance in Burlington, VT. The assigned NPI number for this provider is 1306870381 and is registered as an organization entity type.
The provider Is Doing Business As Burlington Fire Department Ambulance.

The provider's business address is:

136 S WINOOSKI AVE
BURLINGTON, VT
ZIP 05401-313
Phone: (802) 658-9423

The provider's authorized official is Lise Veronneau .
The authorized official title is Business Administrator and has the following contact phone number (802) 658-2704.

The enumeration date for this NPI number is 7/10/2006 and was last updated on 7/8/2007.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1164466439 FLETCHER ALLEN COORDINATED TRANSPORT, LLC
Ambulance (Land Transport)
1043211618 CITY OF SO BURLINGTON
Ambulance
1679552723 UNIVERSITY OF VERMONT AND STATE AGRICULTURAL COLLEGE
Ambulance

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 3416L0300X Ambulance Land Transport 0301 VT Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 0006398 MEDICAID VT
2 VT6398 MEDICARE ID-TYPE UNSPECIFIED VT
3 329655 OTHER VT MVP HEALTHCARE

NPI Record

No. Field Name Field Value
1 NPI 1306870381
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name CITY OF BURLINGTON VERMONT
5 Provider Other Organization Name BURLINGTON FIRE DEPARTMENT AMBULANCE
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 136 S WINOOSKI AVE
8 Provider Business Practice Location Address City Name BURLINGTON
9 Provider Business Practice Location Address State Name VT
10 Provider Business Practice Location Address Postal Code 054018313
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 8026589423
13 Provider Enumeration Date 7/10/2006
14 Last Update Date 7/8/2007
15 Authorized Official Last Name VERONNEAU
16 Authorized Official First Name LISE
17 Authorized Official Title or Position BUSINESS ADMINISTRATOR
18 Authorized Official Telephone Number 8026582704
19 Healthcare Provider Taxonomy Code 1 3416L0300X
20 Provider License Number 1 0301
21 Provider License Number State Code 1 VT
22 Healthcare Provider Primary Taxonomy Switch 1 Y
23 Other Provider Identifier 1 0006398
24 Other Provider Identifier Type Code 1 05
25 Other Provider Identifier State 1 VT
26 Other Provider Identifier 2 VT6398
27 Other Provider Identifier Type Code 2 04
28 Other Provider Identifier State 2 VT
29 Other Provider Identifier 3 329655
30 Other Provider Identifier Type Code 3 01
31 Other Provider Identifier State 3 VT
32 Other Provider Identifier Issuer 3 MVP HEALTHCARE

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This page was last updated on: 8/12/2014
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