1518969534 NPI number — TOWN OF ARLINGTON

Table of content: (NPI 1518969534)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518969534 NPI number — TOWN OF ARLINGTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF ARLINGTON
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:
6
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:
1518969534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
87 MYSTIC ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02474-1129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-859-1330
Provider Business Mailing Address Fax Number:
781-643-0409

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
112 MYSTIC ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02474-1152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-316-3000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/10/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JEFFERSON
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF
Authorized Official Telephone Number:
781-316-3000

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  3211 , 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: 444590809 . This is a "RR MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 701528 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 035959 . This is a "MASS MEDEX" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 103474800 . This is a "DEPARTMENT OF LABOR" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1708058 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 035959 . This is a "BC/BS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 801807 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0008587 . This is a "NEIGHBORHOOD HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 110027969B , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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