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General NPI Number Information
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NPI Number | 1104819572
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Entity Type | Organization
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Legal Business Name | TOWN OF BILLERICA
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Dates
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Enumeration Date | 08/31/2005
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 6 GOOD ST
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City | BILLERICA
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State | MA
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Zip | 01821-1807
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Country | US
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Telephone | 978-671-0900
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Fax |
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Provider Business Mailing Address
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Address Line | 19 NORFOLK AVE STE B
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City | SOUTH EASTON
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State | MA
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Zip | 02375-1911
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Country | US
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Telephone | 888-771-6115
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Fax | 508-297-2699
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Authorized Official
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Title or Position | CHIEF
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Name | DANIEL ROSA
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Credential |
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Telephone | 978-671-0900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 3055
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License Number State | MA
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