# AMBULANCE SERVICE OF MANCHESTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063529741
- **Authorized official:** MR. WAYNE ALFRED WRIGHT (PRESIDENT)
- **Authorized official phone:** (860) 647-9798

## Contact information

- **Practice address:** 275 NEW STATE RD, MANCHESTER, CT 06042-1810
- **Practice address phone:** (860) 647-9798
- **Practice address fax:** (860) 645-8738
- **Mailing address:** PO BOX 300, MANCHESTER, CT 06045-0300
- **Mailing address phone:** (860) 647-9798
- **Mailing address fax:** (860) 645-8738

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | L077P2 | CT | Yes |

## Other

- **Enumeration date:** 08/25/2006
- **Last updated:** 05/14/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004205052 | — | CT |