Provider Demographics
NPI:1801858691
Name:CITY OF WOBURN
Entity Type:Organization
Organization Name:CITY OF WOBURN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:TORTALANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-932-4581
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:
Practice Address - Street 1:124 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-5640
Practice Address - Country:US
Practice Address - Phone:781-932-4581
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3595341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA010559OtherBLUE CROSS BLUE SHIELD
MA1709186Medicaid
973180OtherNETWORK HEALTH
802920OtherTUFTS HEALTH PLAN
000000025587OtherBMC HEALTHNET PLAN
0011700OtherNEIGHBORHOOD HEALTH
700503OtherHARVARD PILGRIM
MA010559OtherBLUE CROSS BLUE SHIELD