Provider Demographics
NPI:1962490334
Name:TOWN OF WINCHESTER
Entity Type:Organization
Organization Name:TOWN OF WINCHESTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED AGENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:T
Authorized Official - Last Name:GENTILE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-452-8191
Mailing Address - Street 1:PO BOX 290184
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06129-0184
Mailing Address - Country:US
Mailing Address - Phone:800-452-8191
Mailing Address - Fax:860-563-3403
Practice Address - Street 1:6 PARKER ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03470-2902
Practice Address - Country:US
Practice Address - Phone:603-239-6691
Practice Address - Fax:603-239-8294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0122341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590015147OtherRAILROAD MEDICARE
NH3086319Medicaid
NH3086319Medicaid