Provider Demographics
NPI:1811190648
Name:PLYMOUTH COUNTY SHERIFF'S DEPARTMENT
Entity Type:Organization
Organization Name:PLYMOUTH COUNTY SHERIFF'S DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOWARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-830-6200
Mailing Address - Street 1:26 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-2606
Mailing Address - Country:US
Mailing Address - Phone:508-830-6200
Mailing Address - Fax:508-830-6217
Practice Address - Street 1:26 LONG POND RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-2606
Practice Address - Country:US
Practice Address - Phone:508-830-6200
Practice Address - Fax:508-830-6217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAH1974434171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAH1974434OtherCONTRACTOR