Provider Demographics
NPI:1053351270
Name:TOWN OF WINCHENDON
Entity type:Organization
Organization Name:TOWN OF WINCHENDON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-297-5415
Mailing Address - Street 1:9 MAIN ST
Mailing Address - Street 2:SUITE 2K
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-1660
Mailing Address - Country:US
Mailing Address - Phone:508-476-9740
Mailing Address - Fax:508-476-9748
Practice Address - Street 1:405 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:WINCHENDON
Practice Address - State:MA
Practice Address - Zip Code:01475-1406
Practice Address - Country:US
Practice Address - Phone:978-297-2323
Practice Address - Fax:978-297-2550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1701428Medicaid
MA016359OtherBCBS PROVIDER NUMBER
MA016359Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER