Provider Demographics
NPI:1720034812
Name:TOWN OF NORTHBRIDGE
Entity Type:Organization
Organization Name:TOWN OF NORTHBRIDGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:NESTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-234-8448
Mailing Address - Street 1:9 MAIN ST
Mailing Address - Street 2:SUITE 2K
Mailing Address - City:SUTTON
Mailing Address - State:MA
Mailing Address - Zip Code:01590-1660
Mailing Address - Country:US
Mailing Address - Phone:508-476-9740
Mailing Address - Fax:508-476-9748
Practice Address - Street 1:193 MAIN ST
Practice Address - Street 2:
Practice Address - City:WHITINSVILLE
Practice Address - State:MA
Practice Address - Zip Code:01588-2214
Practice Address - Country:US
Practice Address - Phone:508-234-8448
Practice Address - Fax:508-234-3682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1701193Medicaid
MA106059OtherBCBS PROVIDER NUMBER
MA011759Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER