Healthcare Provider Details

I. General information

NPI: 1619013653
Provider Name (Legal Business Name): MARLBORO HUDSON AMBULANCE AND WHEELCHAIR SERVICE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CEDAR HILL STREET
MARLBORO MA
01752-3036
US

IV. Provider business mailing address

PO BOX 100330
ATLANTA GA
30384-0330
US

V. Phone/Fax

Practice location:
  • Phone: 978-562-1777
  • Fax: 978-562-5154
Mailing address:
  • Phone: 800-913-9106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3036
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number3036
License Number StateMA

VIII. Authorized Official

Name: TIMOTHY JOSEPH DORN
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 833-703-2294