Healthcare Provider Details

I. General information

NPI: 1275861643
Provider Name (Legal Business Name): TOWN OF WILTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2009
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 FOREST RD
WILTON NH
03086
US

IV. Provider business mailing address

70 MAIN ST UNIT 200
PETERBOROUGH NH
03458-2467
US

V. Phone/Fax

Practice location:
  • Phone: 603-654-2222
  • Fax: 603-654-3307
Mailing address:
  • Phone: 603-924-7797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number0121
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0121
License Number StateNH

VIII. Authorized Official

Name: KELLI SUE BOISSONAULT
Title or Position: CHAIRPERSON
Credential:
Phone: 570-271-1120