Provider Demographics
NPI:1821116930
Name:TOWN OF BRISTOL
Entity Type:Organization
Organization Name:TOWN OF BRISTOL
Other - Org Name:BRISTOL FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-253-6912
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 1:4 ANNAWAMSCUTT DR
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:RI
Practice Address - Zip Code:02809-4200
Practice Address - Country:US
Practice Address - Phone:401-253-6912
Practice Address - Fax:401-253-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI74341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
8190294OtherUNITED HEALTH
RI9007792Medicaid
RI404982OtherBLUECHIP
RI7792OtherBLUECROSS BLUESHIELD
RI590013487OtherRAILROAD MEDICARE
RI599007792Medicare PIN