Provider Demographics
NPI:1447425681
Name:TOWN OF WESTON
Entity Type:Organization
Organization Name:TOWN OF WESTON
Other - Org Name:BOARD OF HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-893-7320
Mailing Address - Street 1:11 TOWNHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-2000
Mailing Address - Country:US
Mailing Address - Phone:781-893-7320
Mailing Address - Fax:781-529-0105
Practice Address - Street 1:11 TOWNHOUSE RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-2000
Practice Address - Country:US
Practice Address - Phone:781-893-7320
Practice Address - Fax:781-529-0105
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF WESTON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11091OtherMEDICARE PART B PROVIDER