Provider Demographics
NPI:1982604849
Name:TOWN OF BRANFORD
Entity Type:Organization
Organization Name:TOWN OF BRANFORD
Other - Org Name:BRANFORD FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHONEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-488-7266
Mailing Address - Street 1:45 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3010
Mailing Address - Country:US
Mailing Address - Phone:203-488-7266
Mailing Address - Fax:203-315-3349
Practice Address - Street 1:45 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3010
Practice Address - Country:US
Practice Address - Phone:203-488-7266
Practice Address - Fax:203-315-3349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004048021Medicaid
00404802100OtherBLUE CARE FAMILY
CT710C014A2CT01OtherBLUE CROSS/BLUE SHIELD
004048021OtherPREFERRED ONE
441590934OtherRAILROAD MEDICARE
OR0860OtherHEALTHNET
441590934OtherRAILROAD MEDICARE
441590934OtherRAILROAD MEDICARE