Provider Demographics
NPI:1255348975
Name:CITY OF LEOMINSTER
Entity type:Organization
Organization Name:CITY OF LEOMINSTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER, CITY OF LEOMINSTER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:R
Authorized Official - Last Name:LAPLANTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-534-7509
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:978-356-2721
Practice Address - Street 1:19 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-3110
Practice Address - Country:US
Practice Address - Phone:978-534-7545
Practice Address - Fax:978-537-6567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32883416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1700294Medicaid
MA011459OtherBLUE CROSS PROVIDER NUMBR
MA0012583OtherNEIGHBORHOOD HEALTH PLAN
MA590006997OtherRAILROAD MEDICARE
MA011459OtherBLUE CROSS PROVIDER NUMBR