Provider Demographics
NPI:1801966536
Name:CITY OF PEABODY
Entity type:Organization
Organization Name:CITY OF PEABODY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR HEALTH & HUMAN SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-538-5926
Mailing Address - Street 1:24 LOWELL ST
Mailing Address - Street 2:HEALTH DEPARTMENT
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-5449
Mailing Address - Country:US
Mailing Address - Phone:978-538-5926
Mailing Address - Fax:978-538-5990
Practice Address - Street 1:24 LOWELL ST
Practice Address - Street 2:HEALTH DEPARTMENT
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-5449
Practice Address - Country:US
Practice Address - Phone:978-538-5926
Practice Address - Fax:978-538-5990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11080Medicare ID - Type UnspecifiedCITY OF PEABODY