MEDICARE: FALLON EMERGENCY MEDICAL SERVICES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	3900	MA

General Provider Information

NPI Number	:	1225282619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FALLON EMERGENCY MEDICAL SERVICES, INC.

Provider Business Mailing Address
First Line	:	111 BROOK RD
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-6528
Country	:	US
Telephone Number	:	617-745-2100
Fax Number	:	617-801-8025

Provider Business Practice Location Address
First Line	:	111 BROOK RD
Second Line	:
City	:	QUINCY
State	:	MA
Zip	:	02169-6528
Country	:	US
Telephone Number	:	617-745-2100
Fax Number	:	617-801-8025

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. PATRICK SEAN TYLER
Credential	:
Telephone Number	:	617-745-2168

Provider Enumeration Date	:	11/11/2008
Last Update Date	:	11/11/2008

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