Status: Active
Founded: 2008
Service Area: Clarksville, Colebrook, Columbia, Dixville, Pittsburg, and Stewartstown (NH), as well as Canaan and Norton (VT)
Number of Bases: 1
Annual Run Volume (2024): 1,321
Dispatched By: Northern Borders Dispatch

45th Parallel EMS is a non-profit regional ambulance service established in 2008 following the closure of volunteer ambulance services in Colebrook and Pittsburg after hospital funding for those services ended. The new organization was formed to ensure continued 911 emergency medical coverage for communities in northern Coös County in New Hampshire and Essex County in Vermont.

The service currently provides coverage to Clarksville, Colebrook, Columbia, Dixville, Pittsburg, and Stewartstown in New Hampshire, as well as Canaan and Norton in Vermont. It also serves seven additional unincorporated communities in Vermont. Altogether, its response area encompasses approximately 1,200 square miles. At its inception, the agency operated out of a trailer at Upper Connecticut Valley Regional Hospital before relocating to a custom-built station in Colebrook. It maintains a fleet of four ambulances.

45th Parallel EMS provides 24/7 ALS-level emergency medical coverage with at least two providers on duty at all times. The service is dispatched by Northern Borders Dispatch.

Dispatch Tone Recordings
Primary dispatch tone

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Status: Active
Founded: 1992
NH Operations Start Date: TBD
Service Area: Manchester and Nashua
Number of Bases: 2
Annual Run Volume (2024): TBD
Dispatched By: Manchester Fire Alarm, Nashua Fire Alarm

TBD

Dispatch Tone Recordings
Manchester
Nashua

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Status: Active
Founded: 2022
Service Area: Gilsum, Harrisville, Marlborough, Richmond, Stoddard, Swanzey, and Westmoreland
Number of Bases: 2
Annual Run Volume (projected): 2,200
Dispatched By: SWNH

Cheshire County EMS is a municipal, county-based service established in 2022 and operating under the authority of the Cheshire County Commissioners. The agency was initially formed with the intention of taking over the DiLuzio Ambulance fleet and equipment after its operators requested help in finding new ownership. That deal ultimately fell through before it could be completed. Instead, Cheshire County decided to build the agency from scratch. It began interfacility transfers in 2022 from a base at the Maplewood Nursing Home in Westmoreland while a dedicated facility was being built on Lake Street in Swanzey. Upon completion of the new station, the Westmoreland base continued to be staffed for communities in the northwestern part of the county.

In April of 2023, DiLuzio let the county know that it would be shutting down by May, leaving seven communities that had contracts with the outgoing service in need of a new EMS provider. These towns—Gilsum, Harrisville, Marlborough, Richmond, Stoddard, Swanzey, and Westmoreland—all signed with Cheshire County to ensure uninterrupted 911 service starting in May. Additional towns contracted with them to provide ALS intercept, including Alstead, Fitzwilliam, Marlow, Troy, Walpole, and Winchester.

The service provides 24/7 ALS coverage from its two stations, with 11 providers on duty staffing five ambulances and one flycar. Units operate in a white and navy striped livery. The service is dispatched by Southwestern New Hampshire District Fire Mutual Aid (SWNH) and participates in the regional mutual aid system.

Dispatch Tone Recordings
Cheshire County EMS

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Status: Active
Founded: 2024
Service Area: Pembroke
Number of Bases: 1
Annual Run Volume (2024): 648
Dispatched By: Capital Area Fire Mutual Aid Compact

Pembroke EMS was established on July 1st, 2024, following the dissolution of Tri-Town EMS after Allenstown began operating its own municipal ambulance service. This effectively ended the regional Tri-Town model (Hooksett had previously withdrawn following 2012) and required Pembroke to establish an independent, municipally operated EMS agency.

The new department retained space within the Pembroke Public Safety Building formerly occupied by Tri-Town EMS and assumed an ambulance designated as Ambulance 8. A second ambulance was placed in service the following year, resulting in the original unit being redesignated as Ambulance 9.

Pembroke EMS provides 24/7 emergency coverage at the ALS level with two providers on duty at all times. The second ambulance is staffed by call members as needed. The service is dispatched by Concord Fire Alarm and participates in the Capital Area Fire Mutual Aid Compact, both providing and receiving mutual aid with surrounding communities. The formation of Pembroke EMS marked a broader regional shift from shared hospital-supported EMS systems toward independent municipal ambulance services.

Dispatch Tone Recordings
Pembroke EMS

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Status: Active
Founded: 2025
Service Area: TBD
Number of Bases: 2
Annual Run Volume (2025): 2,448
Dispatched By: Plaistow Police

TBD

Dispatch Tone Recordings
Plaistow ALS

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Status: Defunct
Founded: 1979
Ceased Operations: 2011
Service Area: Candia, Manchester, Nashua
Number of Bases: 2
Annual Run Volume (2006): 18,206
Dispatched By: Manchester Fire Alarm, Nashua Fire Alarm

Rockingham Regional Ambulance was a regional, ALS-level EMS service that was funded primarily by St. Joseph’s Hospital in Nashua. It served that city from its inception in 1979 through its demise in 2011. In addition to Nashua, Rockingham served Manchester between 1993 and 2011 and Candia from 2001 to 2011.

Up to seven staffed units were shared between its bases at 31 Auburn Street in Manchester and 380 West Hollis Street in Nashua, with Manchester-based units responding to Candia. Units typically rode on Ford E-Series chassis with a white box, navy-blue striping, and large “Rockingham” side lettering. Manchester utilized ALS-1 through ALS-4, while Nashua utilized ALS-10 through ALS-12 as its callsigns.

In late 2010, Rockingham ceased operations in Manchester and Candia after AMR was awarded the contract beginning in 2011. In September 2011, St. Joseph Hospital announced it was shutting down the service permanently, citing Medicaid reimbursement cuts in the state budget. Ambulance coverage in Nashua transitioned to AMR, ending more than three decades of hospital-based EMS service in the city.

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Status: Defunct
Founded: 1977
Ceased Operations: 2025
Service Area: Benton, Dorchester, Groton, Piermont, Warren, Wentworth
Number of Bases: 1
Annual Run Volume (2024): 293
Dispatched By: Lakes Regional Mutual Fire Aid

Warren-Wentworth EMS was an independent, non-profit ambulance service that served multiple towns in the Baker River Valley. Its roots trace back to the inception of the Warren FAST Squad in 1977, which was renamed to the Warren-Wentworth FAST Squad in 1980. At that time, the agency only provided first-response care, with transport being handled by Plymouth or Woodsville. In 1981, it purchased its first used ambulance and began transport service. The ambulance was housed at the Warren Fire Department on Water Street, and dispatch was handled by staff at the Glencliff Home for the Elderly.

In 1993, the service renamed itself to Warren-Wentworth EMS. In 1997, the service transitioned dispatch to Lakes Region Mutual Fire Aid (LRMFA) in Laconia and was assigned radio identifier 24. In 2000, a two-bay station was built on NH 25 and housed up to three ambulances. It added its first paramedic to the roster in 2005, and by 2008 had begun daytime staffing at the station with 2 EMTs.

In addition to serving Warren and Wentworth, the service had contracts with businesses such as Glencliff Home and local racetracks. They also started providing EMS response for parts of Benton, Dorchester, Piermont, and Groton. By the late 2010s, the service had transitioned to 24/7 staffing.

In 2024, a budget shortfall led to an emergency funding request to Warren and Wentworth, which was granted. However, this was a stopgap measure and, in July 2025 following more financial turmoil, the remaining staff quit, ending operations. The ambulances were sold off later that year. Plymouth, Rumney, Woodsville, and Upper Valley Ambulance all volunteered to provide interim coverage until a more permanent solution could be found. Eventually, Warren and Wentworth selected Plymouth for EMS service through the beginning of 2026.

Dispatch Tone Recordings
Warren-Wentworth EMS