MEDICARE: TOWN OF WEST SPRINGFIELD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance	3343	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	803886	OTHER	MA	TUFTS HEALTH PLAN PROV #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063563302
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF WEST SPRINGFIELD

Provider Business Mailing Address
First Line	:	9 MAIN ST
Second Line	:	SUITE 2K
City	:	SUTTON
State	:	MA
Zip	:	01590-1660
Country	:	US
Telephone Number	:	508-476-9740
Fax Number	:	508-476-9748

Provider Business Practice Location Address
First Line	:	44 VAN DEENE AVE
Second Line	:
City	:	WEST SPRINGFIELD
State	:	MA
Zip	:	01089-3214
Country	:	US
Telephone Number	:	413-263-3385
Fax Number	:	413-736-0087

Authorized Official
Title or Position	:	DEPUTY CHIEF, AMBULANCE ADM
Name	:	MR. WILLIAM MICHAEL FLAHERTY
Credential	:	EMT
Telephone Number	:	413-263-3385

Provider Enumeration Date	:	01/15/2007
Last Update Date	:	10/26/2009

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Directions to “TOWN OF WEST SPRINGFIELD ” Practice Location

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