Provider Demographics
NPI:1427145929
Name:TOWN OF BRUNSWICK
Entity type:Organization
Organization Name:TOWN OF BRUNSWICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:COFFILL
Authorized Official - Last Name:DARLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-725-6652
Mailing Address - Street 1:28 FEDERAL ST
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-1510
Mailing Address - Country:US
Mailing Address - Phone:207-725-6652
Mailing Address - Fax:207-725-4107
Practice Address - Street 1:21 TOWN HALL PL
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-2003
Practice Address - Country:US
Practice Address - Phone:207-725-5541
Practice Address - Fax:207-725-6638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
001175OtherANTHEM BLUE CROSS
ME136240000Medicaid
ME136240000Medicaid