Healthcare Provider Details

I. General information

NPI: 1821035619
Provider Name (Legal Business Name): TOWN OF BARRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 03/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 BROAD ST
BARRE MA
01005-9257
US

IV. Provider business mailing address

40 WEST STREET
BARRE MA
01005-9290
US

V. Phone/Fax

Practice location:
  • Phone: 508-688-7730
  • Fax: 978-355-6152
Mailing address:
  • Phone: 978-355-2504
  • Fax: 978-355-5023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3262
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MR. CHARLES F FULLAM
Title or Position: EMS ADMINISTRATOR
Credential:
Phone: 508-688-7730