Provider Demographics
NPI:1154396406
Name:TOWN OF CARROLL
Entity type:Organization
Organization Name:TOWN OF CARROLL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLESON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-846-5545
Mailing Address - Street 1:PO BOX 9150
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-9150
Mailing Address - Country:US
Mailing Address - Phone:270-744-9600
Mailing Address - Fax:270-744-8642
Practice Address - Street 1:100 SCHOOL STREET
Practice Address - Street 2:
Practice Address - City:TWIN MOUNTAIN
Practice Address - State:NH
Practice Address - Zip Code:03595
Practice Address - Country:US
Practice Address - Phone:603-846-5545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-21
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30851814Medicaid
71Y002254NH01OtherANTHEM BCBS
MAZ34827OtherBLUE CROSS BLUE SHIELD
702524OtherHARVARD PILGRIM
NH710580900OtherDOL - FECA/ BL/ ENERGY
590014897OtherRR MEDICARE
804220OtherTUFTS HEALTH PLAN