Provider Demographics
NPI:1902924418
Name:TOWN OF NORTH PROVIDENCE
Entity type:Organization
Organization Name:TOWN OF NORTH PROVIDENCE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HORAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-231-8505
Mailing Address - Street 1:1835 MINERAL SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-3834
Mailing Address - Country:US
Mailing Address - Phone:401-231-8505
Mailing Address - Fax:401-228-3099
Practice Address - Street 1:1835 MINERAL SPRING AVE
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-3834
Practice Address - Country:US
Practice Address - Phone:401-231-8505
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
RI233416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
8109473OtherUNITED HEALTH
RI203820OtherBLUECHIP
RI9971OtherBLUECROSS BLUESHIELD
RI9009971Medicaid
RI203820OtherBLUECHIP