=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972837151
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TOWN OF HOPEDALE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/22/2009
-----------------------------------------------------
Last Update Date | 09/22/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 78 HOPEDALE ST
-----------------------------------------------------
City | HOPEDALE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01747-1742
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-634-2203
-----------------------------------------------------
Fax | 508-634-2203
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 7
-----------------------------------------------------
City | HOPEDALE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01747-0007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-634-2203
-----------------------------------------------------
Fax | 508-634-2203
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HEALTH AGENT
-----------------------------------------------------
Name | MR. LEONARD ANDREW IZZO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 508-634-2203
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251K00000X
-----------------------------------------------------
Taxonomy Name | Public Health or Welfare Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------