1689658106 NPI number — TOWN OF MEDFIELD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689658106 NPI number — TOWN OF MEDFIELD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF MEDFIELD
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:
1689658106
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/19/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
112 NORTH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEDFIELD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02052-1611
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-359-2323
Provider Business Mailing Address Fax Number:
508-359-2212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 NORTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEDFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02052-1611
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-359-2323
Provider Business Practice Location Address Fax Number:
508-359-2212
Provider Enumeration Date:
11/30/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ANDEXLER
Authorized Official First Name:
NICHOLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
CAPTAIN/EMS COORDINTOR
Authorized Official Telephone Number:
508-359-2323

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3018 , 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: 700282 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 608820700 . This is a "US DEPARTMENT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0021970 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590009163 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1701096 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 804726 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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