Provider Demographics
NPI:1275603987
Name:TOWN OF LONGMEADOW
Entity Type:Organization
Organization Name:TOWN OF LONGMEADOW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-565-4110
Mailing Address - Street 1:20 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-1950
Mailing Address - Country:US
Mailing Address - Phone:413-565-4110
Mailing Address - Fax:413-565-4112
Practice Address - Street 1:20 WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:LONGMEADOW
Practice Address - State:MA
Practice Address - Zip Code:01106-1950
Practice Address - Country:US
Practice Address - Phone:413-565-4110
Practice Address - Fax:413-565-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY10374Medicare PIN