1649250127 NPI number — TOWN OF SHARON

Table of content: (NPI 1649250127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649250127 NPI number — TOWN OF SHARON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF SHARON
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:
Provider Other Organization Name Type Code:
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:
1649250127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
31 SMITH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02138-1007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-682-1839
Provider Business Mailing Address Fax Number:
617-492-0344

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 S MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHARON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02067-2528
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-784-1522
Provider Business Practice Location Address Fax Number:
781-784-1521
Provider Enumeration Date:
01/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
781-784-1522

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3034 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000025386 . This is a "BMC HEALTHNET PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1701339 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0008641 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 093259 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 441590376 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 700060 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 800929 . This is a "TUFTS HEALH PLAN" identifier . This identifiers is of the category "OTHER".




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