Healthcare Provider Details

I. General information

NPI: 1922549609
Provider Name (Legal Business Name): TOWN OF WENHAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2017
Last Update Date: 03/15/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 MAIN ST
WENHAM MA
01984-1520
US

IV. Provider business mailing address

140 MAIN ST
WENHAM MA
01984-1520
US

V. Phone/Fax

Practice location:
  • Phone: 978-468-5508
  • Fax: 978-468-5509
Mailing address:
  • Phone: 978-468-5508
  • Fax: 978-468-5509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number3991
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JEFFREY BAXTER
Title or Position: CAPTAIN
Credential:
Phone: 978-468-5508