Provider Demographics
NPI:1073601787
Name:TOWN OF ACUSHNET
Entity Type:Organization
Organization Name:TOWN OF ACUSHNET
Other - Org Name:ACUSHNET EMERGENCY MEDICAL SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLAGHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-998-0235
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:60 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-2602
Practice Address - Country:US
Practice Address - Phone:508-998-0235
Practice Address - Fax:508-998-0224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3069146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0589467OtherUS HEALTHCARE
09650OtherNEIGHBORHOOD HEALTH PLAN
802705OtherTUFTS
MA1706802Medicaid
022475OtherBOSTON HEALTHNET
SECUREOther802705
UNITEDOther8109198
032959OtherBLUE CROSS BLUE SHIELD
MAHPHCOther700267
SECUREOther802705
MA032959Medicare PIN