Provider Demographics
NPI:1194893909
Name:TOWN OF BERNARDSTON
Entity type:Organization
Organization Name:TOWN OF BERNARDSTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:E
Authorized Official - Last Name:CORNWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-648-5413
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:20 CHURCH STREET
Mailing Address - City:BERNARDSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01337
Mailing Address - Country:US
Mailing Address - Phone:413-645-5413
Mailing Address - Fax:
Practice Address - Street 1:20 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:BERNARDSTON
Practice Address - State:MA
Practice Address - Zip Code:01337
Practice Address - Country:US
Practice Address - Phone:413-648-5413
Practice Address - Fax:413-648-9318
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF BERNARDSTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-01
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service