Provider Demographics
NPI:1154304723
Name:TOWN OF LEE
Entity Type:Organization
Organization Name:TOWN OF LEE
Other - Org Name:LEE AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:BREAULT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-243-5547
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 1:177 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:MA
Practice Address - Zip Code:01238-1660
Practice Address - Country:US
Practice Address - Phone:413-243-5547
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3359341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA078359OtherBLUE CROSS BLUE SHIELD
MA1714546Medicaid
703100OtherHARVARD PILGRIM
KYMA5918OtherHEALTH NET
802056OtherTUFTS HEALTH PLAN
590166058OtherRR MEDICARE
000000025295OtherBMC HEALTHNET
0020326OtherNEIGHBORHOOD HEALTH
0020326OtherNEIGHBORHOOD HEALTH
017259Medicare PIN