Provider Demographics
NPI:1548338866
Name:FIRST BRANCH AMBULANCE SERVICE INC.
Entity type:Organization
Organization Name:FIRST BRANCH AMBULANCE SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-889-9800
Mailing Address - Street 1:PO BOX 74
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:VT
Mailing Address - Zip Code:05038-0074
Mailing Address - Country:US
Mailing Address - Phone:802-889-9800
Mailing Address - Fax:
Practice Address - Street 1:324 VT RT 110
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:VT
Practice Address - Zip Code:05038
Practice Address - Country:US
Practice Address - Phone:802-685-3112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2010-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT08053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT6481OtherBCBS VT
VT6481Medicaid
VT590011645Medicare ID - Type UnspecifiedRR MEDICARE
VTVT6481Medicare ID - Type Unspecified