Provider Demographics
NPI:1447247887
Name:TOWN OF BROOKFIELD
Entity type:Organization
Organization Name:TOWN OF BROOKFIELD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-867-6036
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:6 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:MA
Practice Address - Zip Code:01506-1612
Practice Address - Country:US
Practice Address - Phone:508-867-6036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-30
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3270341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA7036OtherFALLON
MA1712322Medicaid
MA590005871OtherRR MEDICARE
MA000000022164OtherBMC HEALTHNET PLAN
MA081559OtherBLUE CROSS & BLUE SHIELD
MA700780OtherHARVARD PILGRIM HEALTH CA
MA725431OtherTUFTS HEALTH PLANS
MA0017787OtherNEIGHBORHOOD HEALTH
MA081559OtherBLUE CROSS & BLUE SHIELD
MA7036OtherFALLON