Healthcare Provider Details

I. General information

NPI: 1831187293
Provider Name (Legal Business Name): TOWN OF CANTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

51 RIVER RD
COLLINSVILLE CT
06019-3174
US

IV. Provider business mailing address

8 TURCOTTE MEMORIAL DR
ROWLEY MA
01969-1706
US

V. Phone/Fax

Practice location:
  • Phone: 860-293-2325
  • Fax: 860-693-2371
Mailing address:
  • Phone: 800-488-4351
  • Fax: 978-356-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberC023I1
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberC023I1
License Number StateCT

VIII. Authorized Official

Name: MR. JOHN BUNNELL
Title or Position: ASSISTANT CHIEF
Credential:
Phone: 860-693-7852