Provider Demographics
NPI:1083692776
Name:TOWN OF PLYMOUTH
Entity Type:Organization
Organization Name:TOWN OF PLYMOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:CASINO
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOGSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-536-1253
Mailing Address - Street 1:42 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03264-1236
Mailing Address - Country:US
Mailing Address - Phone:603-536-1253
Mailing Address - Fax:603-536-0035
Practice Address - Street 1:42 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03264-1236
Practice Address - Country:US
Practice Address - Phone:603-536-1253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
700353OtherHARVARD PILGRIM
NH80006290Medicaid
7106290Y0NH01OtherBLUE CROSS BLUE SHIELD
590008029OtherRR MEDICARE
734851OtherTUFTS HEALTH PLAN
700353OtherHARVARD PILGRIM