1023062049 NPI number — TOWN OF ATHOL

Table of content: (NPI 1023062049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023062049 NPI number — TOWN OF ATHOL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF ATHOL
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:
1023062049
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 TURCOTTE MEMORIAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROWLEY
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01969-1706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-488-4351
Provider Business Mailing Address Fax Number:
978-356-2721

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2251 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATHOL
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01331-3526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-249-8275
Provider Business Practice Location Address Fax Number:
978-575-0138
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
978-249-8275

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1715674 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 011059 . This is a "BCBS PROVIDER NUMBER" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 590012170 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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