Healthcare Provider Details

I. General information

NPI: 1154304723
Provider Name (Legal Business Name): TOWN OF LEE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2005
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

177 MAIN ST
LEE MA
01238-1660
US

IV. Provider business mailing address

8 TURCOTTE MEMORIAL DR
ROWLEY MA
01969-1706
US

V. Phone/Fax

Practice location:
  • Phone: 413-243-5547
  • Fax:
Mailing address:
  • Phone: 800-488-4351
  • Fax: 978-356-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number3359
License Number StateMA

VIII. Authorized Official

Name: LISA BREAULT
Title or Position: ADMINISTRATION
Credential:
Phone: 413-243-5547