Healthcare Provider Details

I. General information

NPI: 1205821204
Provider Name (Legal Business Name): TOWN OF BRISTOL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2005
Last Update Date: 10/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 LAKE ST
BRISTOL NH
03222-3572
US

IV. Provider business mailing address

8 TURCOTTE MEMORIAL DR
ROWLEY MA
01969-1706
US

V. Phone/Fax

Practice location:
  • Phone: 603-744-3354
  • Fax:
Mailing address:
  • Phone: 800-488-4351
  • Fax: 978-356-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0014
License Number StateNH

VIII. Authorized Official

Name: STEVE YANNUZZI
Title or Position: CHIEF
Credential:
Phone: 603-744-2632