Provider Demographics
NPI:1730159625
Name:TOWN OF SOUTHBRIDGE
Entity type:Organization
Organization Name:TOWN OF SOUTHBRIDGE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FIRE CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NORMANDIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-764-5430
Mailing Address - Street 1:24 ELM ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01550-2606
Mailing Address - Country:US
Mailing Address - Phone:508-764-5430
Mailing Address - Fax:508-764-0608
Practice Address - Street 1:24 ELM ST
Practice Address - Street 2:
Practice Address - City:SOUTHBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01550-2606
Practice Address - Country:US
Practice Address - Phone:508-764-5430
Practice Address - Fax:508-764-0608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3307341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
590011299OtherRR MEDICARE
MA018559OtherBLUE CROSS BLUE SHIELD
7310OtherFALLON
0014006OtherNEIGHBORHOOD HEALTH
000000026206OtherBMC HEALTHNET PLAN
103500000OtherDEPARTMENT OF LABOR
802122OtherTUFTS HEALTH
713064OtherCONNECTICARE
713064OtherCONNECTICARE
713064OtherCONNECTICARE