Healthcare Provider Details

I. General information

NPI: 1043201908
Provider Name (Legal Business Name): TOWN OF FAIRHAVEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 05/22/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 WASHINGTON ST
FAIRHAVEN MA
02719-4043
US

IV. Provider business mailing address

8 TURCOTTE MEMORIAL DR
ROWLEY MA
01969-1706
US

V. Phone/Fax

Practice location:
  • Phone: 508-994-1428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number3098
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3098
License Number StateMA

VIII. Authorized Official

Name: TIMOTHY FRANCIS
Title or Position: CHIEF
Credential:
Phone: 508-994-1428