Provider Demographics
NPI:1346233715
Name:TOWN OF BOXBOROUGH
Entity Type:Organization
Organization Name:TOWN OF BOXBOROUGH
Other - Org Name:BOXBOROUGH FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-264-1770
Mailing Address - Street 1:PO BOX 4110
Mailing Address - Street 2:DEPT 790
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01888-4110
Mailing Address - Country:US
Mailing Address - Phone:978-264-1770
Mailing Address - Fax:
Practice Address - Street 1:29 MIDDLE RD
Practice Address - Street 2:
Practice Address - City:BOXBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01719-1430
Practice Address - Country:US
Practice Address - Phone:978-263-7546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA36633416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA036459OtherBC/BS OF MASS
MA590013465OtherRR MEDICARE
MA800458OtherTUFTS HEALTH PLAN
MA1715542Medicaid
MA701201OtherHARVARD PILGRIM
MA0020222OtherNEIGHBORHOOD HEALTH