Provider Demographics
NPI:1477537793
Name:TOWN OF NAHANT
Entity Type:Organization
Organization Name:TOWN OF NAHANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:HYDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-581-0079
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 1:67 FLASH RD
Practice Address - Street 2:
Practice Address - City:NAHANT
Practice Address - State:MA
Practice Address - Zip Code:01908-1205
Practice Address - Country:US
Practice Address - Phone:781-581-9927
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2013-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3035341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
702872OtherHARVARD PILGRIM
MA1720031Medicaid
801584OtherTUFTS HEALTH PLAN
MA091059OtherBLUE CROSS BLUE SHIELD
0008281OtherNEIGHBORHOOD HEALTH
RI7822001OtherBLUE CROSS BLUE SHIELD
RI9007822Medicaid
590006368OtherRR MEDICARE
801584OtherTUFTS HEALTH PLAN
RI7822001OtherBLUE CROSS BLUE SHIELD
MA1720031Medicaid