Provider Demographics
NPI:1013509025
Name:TOWN OF LAKEVILLE
Entity Type:Organization
Organization Name:TOWN OF LAKEVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH AGENT
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:CULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-946-3473
Mailing Address - Street 1:346 BEDFORD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02347-2160
Mailing Address - Country:US
Mailing Address - Phone:508-946-3473
Mailing Address - Fax:508-946-3971
Practice Address - Street 1:346 BEDFORD ST STE 1
Practice Address - Street 2:
Practice Address - City:LAKEVILLE
Practice Address - State:MA
Practice Address - Zip Code:02347-2160
Practice Address - Country:US
Practice Address - Phone:508-946-3473
Practice Address - Fax:508-946-3971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare