1720157225 NPI number — TOWN OF GORHAM

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 1720157225 NPI number — TOWN OF GORHAM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF GORHAM
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:
GORHAM EMS
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:
1720157225
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/11/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
347 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GORHAM
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03581-1117
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-466-5611
Provider Business Mailing Address Fax Number:
603-466-3120

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
347 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GORHAM
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03581
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-466-5611
Provider Business Practice Location Address Fax Number:
603-466-3120
Provider Enumeration Date:
11/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CLOUTIER
Authorized Official First Name:
PHILIP
Authorized Official Middle Name:
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
603-466-2549

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  0042 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 441590545 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 3078044 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1720157225 . This is a "ALL OTHERS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




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