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General NPI Number Information
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NPI Number | 1619979796
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Entity Type | Organization
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Legal Business Name | TOWN OF ANDOVER
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 11/15/2012
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Provider Practice Location Address
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Address Line | 32 NORTH MAIN STREET
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City | ANDOVER
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State | MA
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Zip | 01810-3513
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Country | US
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Telephone | 978-475-1281
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Fax | 978-475-6654
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Provider Business Mailing Address
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Address Line | 19 NORFOLK AVENUE
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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 | 508-297-2068
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Fax | 508-297-2699
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Authorized Official
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Title or Position | FIRE CHIEF
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Name | MICHAEL BRENDAN MANSFIELD
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Credential |
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Telephone | 978-475-1281
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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 | 3056
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License Number State | MA
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