Provider Demographics
NPI:1124251327
Name:TOWN OF DUDLEY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:TOWN OF DUDLEY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH AGENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:PURCELL
Authorized Official - Suffix:
Authorized Official - Credentials:RS, RPH
Authorized Official - Phone:508-949-8017
Mailing Address - Street 1:71 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01571-3264
Mailing Address - Country:US
Mailing Address - Phone:508-949-8017
Mailing Address - Fax:508-949-8031
Practice Address - Street 1:71 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-3264
Practice Address - Country:US
Practice Address - Phone:508-949-8017
Practice Address - Fax:508-949-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare