Provider Demographics
NPI:1851810170
Name:TOWN OF ASHFIELD
Entity Type:Organization
Organization Name:TOWN OF ASHFIELD
Other - Org Name:ASHFIELD BOARD OF HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:PUBLIC HEALTH COMMUNITY NURSE
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'GORMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:413-824-2304
Mailing Address - Street 1:412 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ASHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01330-9789
Mailing Address - Country:US
Mailing Address - Phone:413-628-4441
Mailing Address - Fax:
Practice Address - Street 1:412 MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHFIELD
Practice Address - State:MA
Practice Address - Zip Code:01330-9789
Practice Address - Country:US
Practice Address - Phone:413-628-4441
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2017-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA163WC1500X, 261QP0905X, 332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Single Specialty
No332900000XSuppliersNon-Pharmacy Dispensing Site