Provider Demographics
NPI:1720077969
Name:TOWN OF DUXBURY 8038
Entity type:Organization
Organization Name:TOWN OF DUXBURY 8038
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:NORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-934-5693
Mailing Address - Street 1:19 NORFOLK AVE
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:508-297-2068
Mailing Address - Fax:508-297-2699
Practice Address - Street 1:668 TREMONT ST
Practice Address - Street 2:
Practice Address - City:DUXBURY
Practice Address - State:MA
Practice Address - Zip Code:02332-4442
Practice Address - Country:US
Practice Address - Phone:781-934-5693
Practice Address - Fax:781-934-6530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3091341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA079659OtherBLUE CROSS BLUE SHIELD
13818OtherFALLON COMMUNITY HEALTH
801410OtherTUFTS HEALTH PLAN
0007184OtherNEIGHBORHOOD HEALTH
700398OtherHARVARD PILGRIM HEALTH
MA110031078AMedicaid
590004510OtherRR MEDICARE
=========OtherTRICARE
590004510OtherRR MEDICARE