Provider Demographics
NPI:1407823123
Name:TOWN OF WAYLAND
Entity Type:Organization
Organization Name:TOWN OF WAYLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-358-6910
Mailing Address - Street 1:PO BOX 4110, DEPT 5990
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01888-4110
Mailing Address - Country:US
Mailing Address - Phone:508-358-6910
Mailing Address - Fax:
Practice Address - Street 1:38 COCHITUATE RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-1821
Practice Address - Country:US
Practice Address - Phone:508-358-6912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
700480OtherHARVARD PILGRIM
800087OtherTUFTS HEALTH PLAN
0009526OtherNEIGHBORHOOD HEALTH
629402OtherANTHEM BCBS
MA030559OtherBLUE CROSS BLUE SHIELD
MA1706993Medicaid
590001199OtherRR MEDICARE
MA030559OtherBLUE CROSS BLUE SHIELD