Provider Demographics
NPI:1992957880
Name:TOWN OF FAIRHAVEN
Entity type:Organization
Organization Name:TOWN OF FAIRHAVEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BOARD OF HEALTH
Authorized Official - Prefix:MS
Authorized Official - First Name:JEANNINE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-979-4022
Mailing Address - Street 1:40 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-2932
Mailing Address - Country:US
Mailing Address - Phone:508-979-4022
Mailing Address - Fax:508-979-4079
Practice Address - Street 1:40 CENTER ST
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-2932
Practice Address - Country:US
Practice Address - Phone:508-979-4022
Practice Address - Fax:508-979-4079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare