Provider Demographics
NPI:1699710574
Name:TOWN OF WHITMAN
Entity type:Organization
Organization Name:TOWN OF WHITMAN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRENNO
Authorized Official - Suffix:
Authorized Official - Credentials:FC
Authorized Official - Phone:781-447-7626
Mailing Address - Street 1:19 NORFOLK AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1911
Mailing Address - Country:US
Mailing Address - Phone:888-771-6115
Mailing Address - Fax:508-297-2699
Practice Address - Street 1:56 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1324
Practice Address - Country:US
Practice Address - Phone:781-447-7626
Practice Address - Fax:781-447-7623
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31663416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0017211OtherNEIGHBORHOOD HEALTH PLAN
MA039759OtherBLUE CROSS & BLUE SHIELD
MAA093OtherHARVARD PILGRIM HEALTH
MA1709135Medicaid
MA039759Medicare ID - Type Unspecified