Provider Demographics
NPI:1972586493
Name:TOWN OF MATTAPOISETT
Entity type:Organization
Organization Name:TOWN OF MATTAPOISETT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMIN ASSIST EMS/POLICE
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESJARDINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-758-4141
Mailing Address - Street 1:64 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-1591
Mailing Address - Country:US
Mailing Address - Phone:508-758-4141
Mailing Address - Fax:
Practice Address - Street 1:64 COUNTY RD
Practice Address - Street 2:
Practice Address - City:MATTAPOISETT
Practice Address - State:MA
Practice Address - Zip Code:02739-1650
Practice Address - Country:US
Practice Address - Phone:508-758-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3116341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
801027OtherTUFTS HEALTH PLAN
000000025107OtherBMC HEALTHNET
MA1714031Medicaid
0026157OtherNEIGHBORHOOD HEALTH
700025OtherHARVARD PILGRIM
590008942OtherRR MEDICARE
000000025107OtherBMC HEALTHNET
MA1714031Medicaid