Provider Demographics
NPI:1235286782
Name:TOWN OF WINDHAM
Entity type:Organization
Organization Name:TOWN OF WINDHAM
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TOWN SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:HOYT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-734-4170
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:315-635-1789
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:4786 STATE ROUTE 23
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NY
Practice Address - Zip Code:12496-5466
Practice Address - Country:US
Practice Address - Phone:518-734-5574
Practice Address - Fax:518-734-6058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02963416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01786016Medicaid
NY01786016Medicaid
NYA18931Medicare ID - Type UnspecifiedEMPIRE MCR
NY=========001OtherTRICARE NE