Provider Demographics
NPI:1740299320
Name:WEBSTER EMERGENCY MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:WEBSTER EMERGENCY MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILLIARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:508-943-2218
Mailing Address - Street 1:19 NORFOLK AVE
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:508-297-2068
Mailing Address - Fax:508-297-2699
Practice Address - Street 1:67 THOMPSON RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-1418
Practice Address - Country:US
Practice Address - Phone:508-943-2218
Practice Address - Fax:508-943-7329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1715828Medicaid
MA100459OtherBCBS PROVIDER NUMBER
MAAM0038Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER