Healthcare Provider Details

I. General information

NPI: 1841394327
Provider Name (Legal Business Name): TOWN OF MONTAGUE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AVENUE A
TURNERS FALLS MA
01376-1128
US

IV. Provider business mailing address

1 AVENUE A
TURNERS FALLS MA
01376-1128
US

V. Phone/Fax

Practice location:
  • Phone: 413-863-3200
  • Fax: 413-863-3225
Mailing address:
  • Phone: 413-863-3200
  • Fax: 413-863-3225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number225755
License Number StateMA

VIII. Authorized Official

Name: JOAN P PAJAK
Title or Position: PUBLIC HEALTH NURSE
Credential: MS, RN
Phone: 413-863-3200