1366429482 NPI number — TOWN OF PLAINVILLE

Table of content: (NPI 1366429482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366429482 NPI number — TOWN OF PLAINVILLE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF PLAINVILLE
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:
1366429482
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4110
Provider Second Line Business Mailing Address:
DEPT 5850
Provider Business Mailing Address City Name:
WOBURN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01888-4110
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-695-5252
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
190 SOUTH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLAINVILLE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02762-1517
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-695-5252
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ALEXANDER
Authorized Official First Name:
JUSTIN
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
508-695-5252

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  3029 , 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: 1701258 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000000025385 . This is a "BMC HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0009618 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 590006848 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 700057 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 011859 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 80599 . This is a "TUFTS HEALTH PLAN" identifier . This identifiers is of the category "OTHER".




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