Provider Demographics
NPI:1164467015
Name:TOWN OF CARVER
Entity Type:Organization
Organization Name:TOWN OF CARVER
Other - Org Name:CARVER AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:EMS
Authorized Official - Phone:508-866-3433
Mailing Address - Street 1:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:CARVER
Mailing Address - State:MA
Mailing Address - Zip Code:02330-0468
Mailing Address - Country:US
Mailing Address - Phone:508-866-3433
Mailing Address - Fax:508-866-2566
Practice Address - Street 1:110A MAIN ST
Practice Address - Street 2:
Practice Address - City:CARVER
Practice Address - State:MA
Practice Address - Zip Code:02330-1325
Practice Address - Country:US
Practice Address - Phone:508-866-3433
Practice Address - Fax:508-866-2566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30843416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA700192OtherHARVARD PILGRIM HEALTH
MA032859OtherBLUE CROSS & BLUE SHIELD
MA1707833Medicaid
MA032859Medicare PIN