Provider Demographics
NPI:1750569646
Name:TOWN OF WEYMOUTH
Entity type:Organization
Organization Name:TOWN OF WEYMOUTH
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:I
Authorized Official - Last Name:MCCORMACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-340-5008
Mailing Address - Street 1:75 MIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-1359
Mailing Address - Country:US
Mailing Address - Phone:781-340-5008
Mailing Address - Fax:781-682-6112
Practice Address - Street 1:75 MIDDLE ST
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-1359
Practice Address - Country:US
Practice Address - Phone:781-340-5008
Practice Address - Fax:781-682-6112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY10372Medicare PIN