Provider Demographics
NPI:1780664359
Name:TOWN OF DUDLEY
Entity Type:Organization
Organization Name:TOWN OF DUDLEY
Other - Org Name:DUDLEY FIRE AND EMERGENCY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOCHANOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-949-8040
Mailing Address - Street 1:19 NORFOLK AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1911
Mailing Address - Country:US
Mailing Address - Phone:508-297-2068
Mailing Address - Fax:508-297-2699
Practice Address - Street 1:128 W MAIN ST
Practice Address - Street 2:
Practice Address - City:DUDLEY
Practice Address - State:MA
Practice Address - Zip Code:01571-3361
Practice Address - Country:US
Practice Address - Phone:508-949-8040
Practice Address - Fax:508-943-4424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3596341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1700359Medicaid
MA034659OtherBLUE CROSS BLUE SHIELD
MA034659Medicare UPIN