1851482574 NPI number — TOWN OF SPRINGFIELD

Table of content: (NPI 1851482574)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851482574 NPI number — TOWN OF SPRINGFIELD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF SPRINGFIELD
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:
1851482574
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
96 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGFIELD
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05156-3510
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
802-885-2104
Provider Business Mailing Address Fax Number:
802-885-1617

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
77 HARTNESS AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGFIELD
Provider Business Practice Location Address State Name:
VT
Provider Business Practice Location Address Postal Code:
05156-2737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
802-885-9200
Provider Business Practice Location Address Fax Number:
802-885-2070
Provider Enumeration Date:
09/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SOHNGEN
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
802-885-2104

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  1109 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0006427 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".