Healthcare Provider Details

I. General information

NPI: 1255314753
Provider Name (Legal Business Name): TOWN OF LONDONDERRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 01/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 MAMMOTH RD
LONDONDERRY NH
03053-3003
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 603-432-1124
  • Fax:
Mailing address:
  • Phone: 508-476-9740
  • Fax: 508-476-9748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0148
License Number StateNH

VIII. Authorized Official

Name: KEVIN MACCAFFRIE
Title or Position: FIRE CHIEF
Credential:
Phone: 603-432-1124