Provider Demographics
NPI:1376577601
Name:TOWN OF HATFIELD
Entity Type:Organization
Organization Name:TOWN OF HATFIELD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GAGNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-247-0489
Mailing Address - Street 1:PO BOX 161
Mailing Address - Street 2:
Mailing Address - City:WHITINSVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01588-0161
Mailing Address - Country:US
Mailing Address - Phone:508-476-9740
Mailing Address - Fax:508-476-9748
Practice Address - Street 1:59 MAIN ST
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:MA
Practice Address - Zip Code:01038-9702
Practice Address - Country:US
Practice Address - Phone:413-247-0489
Practice Address - Fax:413-247-5029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1710141Medicaid
MA041759OtherBCBS PROVIDER NUMBER
MA041759Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER