Healthcare Provider Details

I. General information

NPI: 1922040211
Provider Name (Legal Business Name): TOWN OF WEST SPRINGFIELD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 CENTRAL ST SUITE 18
WEST SPRINGFIELD MA
01089-2753
US

IV. Provider business mailing address

26 CENTRAL ST SUITE 18
WEST SPRINGFIELD MA
01089-2754
US

V. Phone/Fax

Practice location:
  • Phone: 413-263-3206
  • Fax: 413-737-1583
Mailing address:
  • Phone: 413-263-3206
  • Fax: 413-737-1583

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY E ALLEN
Title or Position: PUBLIC HEALTH NURSE, ADMINISTRATOR
Credential: RN MA 119085 CURRENT
Phone: 413-263-3207