Healthcare Provider Details

I. General information

NPI: 1740219518
Provider Name (Legal Business Name): TOWN OF HOLLISTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

59 CENTRAL ST
HOLLISTON MA
01746-2103
US

IV. Provider business mailing address

1 EDWARD ST
CANTON MA
02021-2303
US

V. Phone/Fax

Practice location:
  • Phone: 508-429-4631
  • Fax: 508-429-0614
Mailing address:
  • Phone: 781-828-3533
  • Fax: 781-828-2471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3010
License Number StateMA

VIII. Authorized Official

Name: MICHAEL P CASSIDY
Title or Position: FIRE CHIEF
Credential: F.C.
Phone: 508-429-4631