Provider Demographics
NPI:1760465256
Name:TOWN OF LITTLE COMPTON
Entity Type:Organization
Organization Name:TOWN OF LITTLE COMPTON
Other - Org Name:LITTLE COMPTON FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:G
Authorized Official - Last Name:PETRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-635-2324
Mailing Address - Street 1:PO BOX 8879
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-0879
Mailing Address - Country:US
Mailing Address - Phone:401-572-3120
Mailing Address - Fax:401-572-3351
Practice Address - Street 1:60 SIMMONS RD
Practice Address - Street 2:
Practice Address - City:LITTLE COMPTON
Practice Address - State:RI
Practice Address - Zip Code:02837-1520
Practice Address - Country:US
Practice Address - Phone:401-635-2324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-29
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI51341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0000024156OtherBLUE CROSS BLUE SHIELD
706239OtherHARVARD PILGRIM
695806OtherTUFTS HEALTH PLAN
RI9024156Medicaid
BQ410960OtherBLUE CHIP
P00055434OtherRR MEDICARE
RI599024156Medicare PIN