Provider Demographics
NPI:1174501308
Name:TOWN OF RUTLAND
Entity type:Organization
Organization Name:TOWN OF RUTLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:RUCHALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-886-4211
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:
Mailing Address - Fax:
Practice Address - Street 1:240 MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:MA
Practice Address - Zip Code:01543-1300
Practice Address - Country:US
Practice Address - Phone:508-886-4211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3697341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
801284OtherTUFTS HEALTH PLAN
MA1707337Medicaid
MA034759OtherBLUE CROSS BLUE SHIELD
0021209OtherNEIGHBORHOOD HEALTH
701933OtherHARVARD PILGRIM
NY137121FWOtherPREFERRED CARE
7300OtherFALLON
MA034759Medicare ID - Type Unspecified