Provider Demographics
NPI:1114905718
Name:TOWN OF PORTSMOUTH
Entity Type:Organization
Organization Name:TOWN OF PORTSMOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-683-1200
Mailing Address - Street 1:PO BOX 8879
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0879
Mailing Address - Country:US
Mailing Address - Phone:401-572-3120
Mailing Address - Fax:401-572-3351
Practice Address - Street 1:2300 E MAIN RD
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:RI
Practice Address - Zip Code:02871-4023
Practice Address - Country:US
Practice Address - Phone:401-683-1200
Practice Address - Fax:401-683-1206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-04
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI29341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0000026690OtherBLUE CROSS BLUE SHIELD
RI590007148OtherRAILROAD MEDICARE
706205OtherHARVARD PILGRIM
820910OtherTUFTS HEALTH PLAN
0000000028100OtherBMC HEALTHNET PLAN
411294OtherBLUE CHIP
RI9026690Medicaid
706205OtherHARVARD PILGRIM