Provider Demographics
NPI:1558354621
Name:TOWN OF BELMONT
Entity Type:Organization
Organization Name:TOWN OF BELMONT
Other - Org Name:BELMONT FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIZZELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-993-2204
Mailing Address - Street 1:PO BOX 4110, DEPT 1700
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:617-682-1854
Mailing Address - Fax:
Practice Address - Street 1:299 TRAPELO RD
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:MA
Practice Address - Zip Code:02478-1855
Practice Address - Country:US
Practice Address - Phone:617-993-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-24
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA800326OtherTUFTS HEALTH PLAN
MA036959OtherBLUE CROSS BLUE SHIELD
MA1708295Medicaid
MA701057OtherHARVARD PILGRIM HEALTHCAR
MA441590895OtherRR MEDICARE