Healthcare Provider Details

I. General information

NPI: 1164574661
Provider Name (Legal Business Name): TOWN OF WHATELY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 CHRISTIAN LANE
WHATELY MA
01093
US

IV. Provider business mailing address

9 MAIN ST SUITE 2K
SUTTON MA
01590-1660
US

V. Phone/Fax

Practice location:
  • Phone: 413-665-4400
  • Fax: 413-665-2230
Mailing address:
  • Phone: 508-476-9740
  • Fax: 508-476-9748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number3382
License Number StateMA

VIII. Authorized Official

Name: MR. JONATHAN S. EDWARDS
Title or Position: CHAIR, BOARD OF SELECTMEN
Credential:
Phone: 413-665-4400