Provider Demographics
NPI:1457334021
Name:TOWN OF LANESBOROUGH
Entity Type:Organization
Organization Name:TOWN OF LANESBOROUGH
Other - Org Name:LANESBOROUGH AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WEBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-441-0270
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:180 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LANESBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01237-9724
Practice Address - Country:US
Practice Address - Phone:413-443-2321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-28
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3358341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA093359OtherBLUE CROSS BLUE SHIELD
0019730OtherNEIGHBORHOOD HEALTH PLAN
680252OtherTUFTS HEALTH PLAN
703598OtherHARVARD PILGRIM
000000025589OtherBMC HEALTHNET
MA1714511Medicaid
590011131OtherRR MEDICARE
590011131OtherRR MEDICARE