Provider Demographics
NPI:1427179324
Name:TOWN OF WARE
Entity Type:Organization
Organization Name:TOWN OF WARE
Other - Org Name:TOWN OF WARE AMBULANCE SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WALTER
Authorized Official - Last Name:COULOMBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-967-9631
Mailing Address - Street 1:19 NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1911
Mailing Address - Country:US
Mailing Address - Phone:508-297-2068
Mailing Address - Fax:508-297-2699
Practice Address - Street 1:200 WEST ST
Practice Address - Street 2:
Practice Address - City:WARE
Practice Address - State:MA
Practice Address - Zip Code:01082-1598
Practice Address - Country:US
Practice Address - Phone:413-967-9631
Practice Address - Fax:413-967-9632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3315341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA010859OtherBLUE CROSS
MA110030738AMedicaid
MA010859OtherMEDICARE PTAN