Healthcare Provider Details

I. General information

NPI: 1851473276
Provider Name (Legal Business Name): TOWN OF ORANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 E MAIN ST
ORANGE MA
01364-6421
US

IV. Provider business mailing address

6 PROSPECT ST
ORANGE MA
01364
US

V. Phone/Fax

Practice location:
  • Phone: 978-544-1107
  • Fax: 978-544-1138
Mailing address:
  • Phone: 978-544-1107
  • Fax: 978-544-1138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROGER W MALLET
Title or Position: AGENT BOARD OF HEALTH
Credential:
Phone: 978-544-1107