Provider Demographics
NPI:1184604985
Name:TOWN OF SANDWICH
Entity type:Organization
Organization Name:TOWN OF SANDWICH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-888-0525
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
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 1:130 MAIN ST
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02563-2208
Practice Address - Country:US
Practice Address - Phone:508-888-0525
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2013-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3142341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
801307OtherTUFTS HEALTH PLAN
MA1706101Medicaid
700074OtherHARVARD PILGRIM
MA030959OtherBLUE CROSS BLUE SHIELD
000000025588OtherBMC HEALTHNET PLAN
0024630OtherNEIGHBORHOOD HEALTH
590002412OtherRR MEDICARE
9572OtherFALLON COMMUNITY HEALTH
MA030959Medicare PIN