Provider Demographics
NPI:1841394327
Name:TOWN OF MONTAGUE
Entity Type:Organization
Organization Name:TOWN OF MONTAGUE
Other - Org Name:MONTAGUE HEALTH DEPARTMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH NURSE
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:PAJAK
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RN
Authorized Official - Phone:413-863-3200
Mailing Address - Street 1:1 AVENUE A
Mailing Address - Street 2:
Mailing Address - City:TURNERS FALLS
Mailing Address - State:MA
Mailing Address - Zip Code:01376-1128
Mailing Address - Country:US
Mailing Address - Phone:413-863-3200
Mailing Address - Fax:413-863-3225
Practice Address - Street 1:1 AVENUE A
Practice Address - Street 2:
Practice Address - City:TURNERS FALLS
Practice Address - State:MA
Practice Address - Zip Code:01376-1128
Practice Address - Country:US
Practice Address - Phone:413-863-3200
Practice Address - Fax:413-863-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA225755163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11038OtherMEDICARE PROVIDER NUMBER