Provider Demographics
NPI:1164556205
Name:TOWN OF MAYNARD AMBULANCE SERVICE
Entity Type:Organization
Organization Name:TOWN OF MAYNARD AMBULANCE SERVICE
Other - Org Name:TOWN OF MAYNARD FIRE DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMIN. ASSIST. TO FIRE CHIEF
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-897-1014
Mailing Address - Street 1:1 SUMMER ST.
Mailing Address - Street 2:
Mailing Address - City:MAYNARD
Mailing Address - State:MA
Mailing Address - Zip Code:01754
Mailing Address - Country:US
Mailing Address - Phone:978-897-1014
Mailing Address - Fax:978-897-3389
Practice Address - Street 1:1 SUMMER ST.
Practice Address - Street 2:
Practice Address - City:MAYNARD
Practice Address - State:MA
Practice Address - Zip Code:01754
Practice Address - Country:US
Practice Address - Phone:978-897-1014
Practice Address - Fax:978-897-3389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA700469OtherHARVARD PILGRIM
MA800152OtherTUFTS
MA800152OtherTUFTS