1689641268 NPI number — TOWN OF WEARE SELECTMEN

Table of content: (NPI 1689641268)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689641268 NPI number — TOWN OF WEARE SELECTMEN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOWN OF WEARE SELECTMEN
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689641268
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 N STARK HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEARE
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03281-4631
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-529-2352
Provider Business Mailing Address Fax Number:
603-529-2379

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 FLANDERS MEMORIAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEARE
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03281-4905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-529-7526
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VEZINA
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
FIRE CHIEF
Authorized Official Telephone Number:
603-529-2352

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  0116 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 590013117 . This is a "RR MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 704034 . This is a "HARVARD PILGRIM HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30011192 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1720031 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7103297Y0NH01 . This is a "ANTHEM BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 091059 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".