Provider Demographics
NPI:1285681353
Name:TOWN OF STOUGHTON
Entity Type:Organization
Organization Name:TOWN OF STOUGHTON
Other - Org Name:STOUGHTON FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-344-3170
Mailing Address - Street 1:PO BOX 4110
Mailing Address - Street 2:DEPT 7360
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01888-4110
Mailing Address - Country:US
Mailing Address - Phone:617-492-8484
Mailing Address - Fax:617-492-0806
Practice Address - Street 1:1550 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:STOUGHTON
Practice Address - State:MA
Practice Address - Zip Code:02072-1600
Practice Address - Country:US
Practice Address - Phone:781-344-3170
Practice Address - Fax:781-341-3927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA014359OtherBCBS PROVIDER NUMBER
MA1706055Medicaid
MA1706055Medicaid