Provider Demographics
NPI:1306115753
Name:TOWN OF GREENFIELD
Entity type:Organization
Organization Name:TOWN OF GREENFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHN
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TUDRYN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:413-824-5855
Mailing Address - Street 1:14 COURT SQ
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01301-3547
Mailing Address - Country:US
Mailing Address - Phone:413-772-1404
Mailing Address - Fax:413-772-2238
Practice Address - Street 1:14 COURT SQ
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3547
Practice Address - Country:US
Practice Address - Phone:413-772-1404
Practice Address - Fax:413-772-2238
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF GREENFIELD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-12-14
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN237763251K00000X
251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare