Provider Demographics
NPI:1225282619
Name:FALLON EMERGENCY MEDICAL SERVICES, INC.
Entity Type:Organization
Organization Name:FALLON EMERGENCY MEDICAL SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-745-2168
Mailing Address - Street 1:111 BROOK RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-6528
Mailing Address - Country:US
Mailing Address - Phone:617-745-2100
Mailing Address - Fax:617-801-8025
Practice Address - Street 1:111 BROOK RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-6528
Practice Address - Country:US
Practice Address - Phone:617-745-2100
Practice Address - Fax:617-801-8025
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FALLON SERVICE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport