Provider Demographics
NPI:1619465853
Name:JAFFREY-RINDGE MEMORIAL AMBULANCE
Entity type:Organization
Organization Name:JAFFREY-RINDGE MEMORIAL AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT,BOARD OF DIRECTORS
Authorized Official - Prefix:MS
Authorized Official - First Name:DONA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFORTUNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-899-6187
Mailing Address - Street 1:294 MIDDLE WINCHENDON RD
Mailing Address - Street 2:
Mailing Address - City:RINDGE
Mailing Address - State:NH
Mailing Address - Zip Code:03461-5636
Mailing Address - Country:US
Mailing Address - Phone:603-899-6187
Mailing Address - Fax:
Practice Address - Street 1:119 MAIN ST
Practice Address - Street 2:
Practice Address - City:JAFFREY
Practice Address - State:NH
Practice Address - Zip Code:03452-6140
Practice Address - Country:US
Practice Address - Phone:603-532-6868
Practice Address - Fax:603-532-2405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-24
Last Update Date:2018-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHS3421548Medicaid