Healthcare Provider Details

I. General information

NPI: 1417917998
Provider Name (Legal Business Name): TOWN OF PEPPERELL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 08/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE MAIN STREET
PEPPERELL MA
01463
US

IV. Provider business mailing address

PO BOX 1174
PEPPERELL MA
01463
US

V. Phone/Fax

Practice location:
  • Phone: 978-433-0303
  • Fax: 978-433-0306
Mailing address:
  • Phone: 978-433-0303
  • Fax: 978-433-0306

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number22D1040298
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3496
License Number StateMA

VIII. Authorized Official

Name: MS. JEAN M TAUBERT
Title or Position: BILLING CLERK / OFFICE MANAGER
Credential:
Phone: 978-433-0303