Provider Demographics
NPI:1306017264
Name:TOWN OF TEWKSBURY
Entity Type:Organization
Organization Name:TOWN OF TEWKSBURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PUBLIC HEALTH
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOU-ANN
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:CHO
Authorized Official - Phone:978-640-4470
Mailing Address - Street 1:999 WHIPPLE RD
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-3756
Mailing Address - Country:US
Mailing Address - Phone:978-640-4470
Mailing Address - Fax:978-640-4472
Practice Address - Street 1:999 WHIPPLE RD
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-3756
Practice Address - Country:US
Practice Address - Phone:978-640-4470
Practice Address - Fax:978-640-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare