Provider Demographics
NPI:1144294430
Name:TOWN OF WAKEFIELD
Entity type:Organization
Organization Name:TOWN OF WAKEFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWN ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DINO
Authorized Official - Middle Name:
Authorized Official - Last Name:SCALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-522-6205
Mailing Address - Street 1:2017 WAKEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SANBORNVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03872-6301
Mailing Address - Country:US
Mailing Address - Phone:603-522-6205
Mailing Address - Fax:
Practice Address - Street 1:2017 WAKEFIELD RD
Practice Address - Street 2:
Practice Address - City:SANBORNVILLE
Practice Address - State:NH
Practice Address - Zip Code:03872-6301
Practice Address - Country:US
Practice Address - Phone:603-522-6205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0330341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
7106342Y0NH01OtherANTHEM BLUE CROSS
701549OtherHARVARD PILGRIM
441590488OtherRR MEDICARE
NH80596342Medicaid
NHNH6342Medicare PIN