Provider Demographics
NPI:1306020516
Name:TOWN OF WILMINGTON
Entity Type:Organization
Organization Name:TOWN OF WILMINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLERK OF PUBLIC HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:
Authorized Official - Last Name:MYTYCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-694-2014
Mailing Address - Street 1:121 GLEN RD
Mailing Address - Street 2:HEALTH DEPT.
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-3500
Mailing Address - Country:US
Mailing Address - Phone:978-694-2014
Mailing Address - Fax:
Practice Address - Street 1:121 GLEN RD
Practice Address - Street 2:HEALTH DEPT.
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-3500
Practice Address - Country:US
Practice Address - Phone:978-694-2014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-24
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare