Provider Demographics
NPI:1437129392
Name:TOWN OF SOUTH HADLEY
Entity type:Organization
Organization Name:TOWN OF SOUTH HADLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AMBULANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-538-5017
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 1:116 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01075-2833
Practice Address - Country:US
Practice Address - Phone:413-538-5017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3334341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000021422OtherBMC HEALTHNET PLAN
701303OtherCONNECTICARE
97115OtherNETWORK HEALTH
MA1705601Medicaid
703527OtherHARVARD PILGRIM
803340OtherTUFTS HEALTH PLAN
MA07559OtherBLUE CROSS BLUE SHIELD
0009692OtherNEIGHBORHOOD HEALTH
97115OtherNETWORK HEALTH