Healthcare Provider Details

I. General information

NPI: 1689657520
Provider Name (Legal Business Name): TOWN OF KINGSTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/23/2005
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 MAIN ST
KINGSTON NH
03848-3222
US

IV. Provider business mailing address

PO BOX 302
KINGSTON NH
03848-0302
US

V. Phone/Fax

Practice location:
  • Phone: 603-642-3626
  • Fax: 603-642-6307
Mailing address:
  • Phone: 603-642-3626
  • Fax: 603-642-6307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0060
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: KELLY O'BRIEN
Title or Position: AUTHORIZED OFFICIAL ADMINISTRATION
Credential:
Phone: 603-642-3626