Provider Demographics
NPI:1790840247
Name:TOWN OF NATICK
Entity Type:Organization
Organization Name:TOWN OF NATICK
Other - Org Name:NATICK BOARD OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:508-647-6460
Mailing Address - Street 1:13 E CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4629
Mailing Address - Country:US
Mailing Address - Phone:508-647-6460
Mailing Address - Fax:508-647-6466
Practice Address - Street 1:13 E CENTRAL ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4629
Practice Address - Country:US
Practice Address - Phone:508-647-6460
Practice Address - Fax:508-647-6466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF NATICK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-26
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11012Medicare PIN