Provider Demographics
NPI:1942451109
Name:TOWN OF FITZWILLIAM
Entity type:Organization
Organization Name:TOWN OF FITZWILLIAM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN ADMINSITRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FAVREAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-585-7723
Mailing Address - Street 1:70 MAIN ST UNIT 200
Mailing Address - Street 2:
Mailing Address - City:PETERBOROUGH
Mailing Address - State:NH
Mailing Address - Zip Code:03458-2467
Mailing Address - Country:US
Mailing Address - Phone:603-924-7797
Mailing Address - Fax:
Practice Address - Street 1:13 TEMPLETON TURNPIKE
Practice Address - Street 2:
Practice Address - City:FITZWILLIAMS
Practice Address - State:NH
Practice Address - Zip Code:03447-0725
Practice Address - Country:US
Practice Address - Phone:603-585-7723
Practice Address - Fax:603-585-7744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0259341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30827085Medicaid
NHP00672352OtherRAILROAD MEDICARE
NHP00672352OtherRAILROAD MEDICARE