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Organization
KILLINGWORTH AMBULANCE ASSOCIATION, INC
Active
Organization
KILLINGWORTH AMBULANCE ASSOCIATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL E O'SULLIVAN (PRESIDENT)
(860) 663-2450
Entity
Organization
Contact information
Practice address
325 ROUTE 81, KILLINGWORTH, CT 06419-9999
(860) 663-3634
(860) 663-3795
Mailing address
195 ROUTE 80, KILLINGWORTH, CT 06419-1400
(860) 663-3634
(860) 663-3795
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
E5415
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004010492
—
CT
01
—
590014003
RAILROAD MEDICARE
CT
01
—
699842
CONNECTICARE
CT
01
—
710C070A2CT01
ANTHEM BLUE CROSS
CT
01
—
CT2195
HEALTHNET
CT
Enumeration date
07/04/2006
Last updated
05/01/2017
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