Healthcare Provider Details

I. General information

NPI: 1720034812
Provider Name (Legal Business Name): TOWN OF NORTHBRIDGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 11/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

193 MAIN ST
WHITINSVILLE MA
01588-2214
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 508-234-8448
  • Fax: 508-234-3682
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 Number
License Number State

VIII. Authorized Official

Name: GARY A. NESTOR
Title or Position: FIRE CHIEF
Credential:
Phone: 508-234-8448