Provider Demographics
NPI:1972638161
Name:TOWN OF CHARLEMONT
Entity Type:Organization
Organization Name:TOWN OF CHARLEMONT
Other - Org Name:CHARLEMONT FIRE DEPARTMENT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EMS COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-339-4090
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:5 FACTORY RD
Practice Address - Street 2:
Practice Address - City:CHARLEMONT
Practice Address - State:MA
Practice Address - Zip Code:01339
Practice Address - Country:US
Practice Address - Phone:413-339-4090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3368341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport