# ESSEX AMBULANCE ASSOCIATION INCORPORATED

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

## Provider details

- **NPI number:** 1093718611
- **Authorized official:** MS. JUDITH A REYNOLDS (TREASURER)
- **Authorized official phone:** (860) 767-1730

## Contact information

- **Practice address:** 149 DENNISON ROAD, CENTERBROOK, CT 06409
- **Practice address phone:** (860) 767-1730
- **Practice address fax:** (860) 767-7677
- **Mailing address:** PO BOX 233, IVORYTON, CT 06442-0233
- **Mailing address phone:** (860) 767-1730
- **Mailing address fax:** (860) 767-7677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | C050B1 | CT | Yes |

## Other

- **Enumeration date:** 05/27/2005
- **Last updated:** 09/16/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004010617 | — | CT |