Provider Demographics
NPI:1396821989
Name:CROSS ROADS TROLLEY, INC
Entity Type:Organization
Organization Name:CROSS ROADS TROLLEY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:KEEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-949-6743
Mailing Address - Street 1:28 BATES POINT RD
Mailing Address - Street 2:P.O. BOX 1153
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-3429
Mailing Address - Country:US
Mailing Address - Phone:508-949-6743
Mailing Address - Fax:
Practice Address - Street 1:257 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-5940
Practice Address - Country:US
Practice Address - Phone:508-949-6743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA970699OtherNETWORK HEALTH
MA102559OtherBLUE CROSS BLUE SHEILD
MA1720058Medicaid
MA1540327Medicaid