Provider Demographics
NPI:1528257151
Name:CITY OF MELROSE
Entity type:Organization
Organization Name:CITY OF MELROSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:781-979-4130
Mailing Address - Street 1:562 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-3142
Mailing Address - Country:US
Mailing Address - Phone:781-979-4130
Mailing Address - Fax:781-979-7696
Practice Address - Street 1:562 MAIN ST
Practice Address - Street 2:
Practice Address - City:MELROSE
Practice Address - State:MA
Practice Address - Zip Code:02176-3142
Practice Address - Country:US
Practice Address - Phone:781-979-4130
Practice Address - Fax:781-979-7696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11085Medicare PIN