Provider Demographics
NPI:1376526897
Name:TOWN OF MANSFIELD
Entity Type:Organization
Organization Name:TOWN OF MANSFIELD
Other - Org Name:MANSFIELD RESCUE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DESROSIERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-261-7490
Mailing Address - Street 1:500 EAST ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02048-2969
Mailing Address - Country:US
Mailing Address - Phone:508-261-7321
Mailing Address - Fax:
Practice Address - Street 1:500 EAST ST STE A
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:MA
Practice Address - Zip Code:02048-2969
Practice Address - Country:US
Practice Address - Phone:508-261-7320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3112341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000024358OtherBMC HEALTHNET
700070OtherHARVARD PILGRIM
MA1701061Medicaid
590011004OtherRR MEDICARE
0009746OtherNEIGHBORHOOD HEALTH
NY160351XXOtherPREFERRED CARE
800902OtherTUFTS HEALTH PLAN
MA1701061Medicaid