Provider Demographics
NPI:1548506843
Name:TOWN OF PEMBROKE
Entity type:Organization
Organization Name:TOWN OF PEMBROKE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMACHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-485-4411
Mailing Address - Street 1:247 PEMBROKE ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NH
Mailing Address - Zip Code:03275-1359
Mailing Address - Country:US
Mailing Address - Phone:603-485-4411
Mailing Address - Fax:603-485-5534
Practice Address - Street 1:247 PEMBROKE ST
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NH
Practice Address - Zip Code:03275-1359
Practice Address - Country:US
Practice Address - Phone:603-485-4411
Practice Address - Fax:603-485-5534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0106341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
P01237528OtherRAILROAD MEDICARE
NH0031497Medicare PIN