Provider Demographics
NPI:1457570525
Name:TOWN OF WESTPORT
Entity type:Organization
Organization Name:TOWN OF WESTPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN NURSE
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:508-636-1030
Mailing Address - Street 1:856 MAIN RD
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:MA
Mailing Address - Zip Code:02790-4311
Mailing Address - Country:US
Mailing Address - Phone:508-636-1030
Mailing Address - Fax:508-636-1016
Practice Address - Street 1:856 MAIN RD
Practice Address - Street 2:TOWN NURSE
Practice Address - City:WESTPORT
Practice Address - State:MA
Practice Address - Zip Code:02790-4311
Practice Address - Country:US
Practice Address - Phone:508-636-1030
Practice Address - Fax:508-636-1016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY11099Medicare ID - Type UnspecifiedPART B PROVIDERNUMBER