Provider Demographics
NPI:1598867624
Name:TOWN OF RAYNHAM
Entity Type:Organization
Organization Name:TOWN OF RAYNHAM
Other - Org Name:RAYNHAM FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:T
Authorized Official - Last Name:JANUSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-824-2713
Mailing Address - Street 1:37 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:RAYNHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02767-5332
Mailing Address - Country:US
Mailing Address - Phone:508-824-2713
Mailing Address - Fax:508-821-3607
Practice Address - Street 1:37 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:RAYNHAM
Practice Address - State:MA
Practice Address - Zip Code:02767-5332
Practice Address - Country:US
Practice Address - Phone:508-824-2713
Practice Address - Fax:508-821-3607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-01
Last Update Date:2011-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31363416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1709356Medicaid
MA0000070859OtherBC BS OF MA
MA0013062OtherNEIGHBORHOOD HEALTH PLAN
MA801556OtherTUFTS HEALTH PLAN
MA0013062OtherNEIGHBORHOOD HEALTH PLAN
MA070859Medicare ID - Type UnspecifiedPROVIDER NUMBER