Provider Demographics
NPI:1255318903
Name:TOWN OF OAK BLUFFS
Entity Type:Organization
Organization Name:TOWN OF OAK BLUFFS
Other - Org Name:OAK BLUFFS AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-693-0077
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 1:6 FIREHOUSE ROAD
Practice Address - Street 2:
Practice Address - City:OAK BLUFFS
Practice Address - State:MA
Practice Address - Zip Code:02557
Practice Address - Country:US
Practice Address - Phone:508-693-0077
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-23
Last Update Date:2013-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3127341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA095559OtherBLUE CROSS BLUE SHIELD
700245OtherHARVARD PILGRIM
000000022680OtherBMC HEALTHNET PLAN
590010121OtherRR MEDICARE
MA1720341Medicaid
9863991OtherG. H. I INSURANCE
801878OtherTUFTS HEALTH PLAN
9863991OtherG. H. I INSURANCE
700245OtherHARVARD PILGRIM