1376526897 NPI number — TOWN OF MANSFIELD

Table of content: (NPI 1376526897)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376526897 NPI number — TOWN OF MANSFIELD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF MANSFIELD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MANSFIELD RESCUE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1376526897
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 EAST ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANSFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02048-2969
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-261-7321
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 EAST ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANSFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02048-2969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-261-7320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
DESROSIERS
Authorized Official First Name:
JUSTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
508-261-7490

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3112 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000024358 . This is a "BMC HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 700070 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1701061 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590011004 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0009746 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 160351XX . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 800902 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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