Provider Demographics
NPI:1396729604
Name:TOWN OF MIDDLETOWN
Entity type:Organization
Organization Name:TOWN OF MIDDLETOWN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYN
Authorized Official - Middle Name:
Authorized Official - Last Name:DIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-846-4478
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 1:350 E MAIN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-7264
Practice Address - Country:US
Practice Address - Phone:401-846-4478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-30
Last Update Date:2013-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI53341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0000027583OtherBLUE CROSS BLUE SHIELD
807838OtherTUFTS HEALTH PLAN
RI9003332Medicaid
AA6127OtherHARVARD PILGRIM
BQ411580OtherBLUE CHIP
AA6127OtherHARVARD PILGRIM
RI9003332Medicaid