Provider Demographics
NPI:1184608580
Name:CITY OF METHUEN
Entity type:Organization
Organization Name:CITY OF METHUEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:T
Authorized Official - Last Name:SHEEHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-983-8912
Mailing Address - Street 1:19 NORFOLK AVE STE B
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1911
Mailing Address - Country:US
Mailing Address - Phone:888-771-6115
Mailing Address - Fax:508-297-2699
Practice Address - Street 1:24 LOWELL ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-6825
Practice Address - Country:US
Practice Address - Phone:978-983-8910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3059341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
802321OtherTUFTS HEALTH
701299OtherHARVARD PILGRIM
0008643OtherNEIGHBORHOOD HEALTH
103492300OtherUS DEPARTMENT OF LABOR
MA018159OtherBCBS
MA1701126Medicaid
590006024OtherRR MEDICARE
MA018159OtherBCBS
MA018159Medicare ID - Type Unspecified