# DURHAM VOLUNTEER AMBULANCE CORPS INC

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

## Provider details

- **NPI number:** 1114973245
- **Authorized official:** MR. THOMAS WIMLER (CHIEF OF SERVICE)
- **Authorized official phone:** (860) 349-9966

## Contact information

- **Practice address:** 205 MAIN ST, DURHAM, CT 06422-2108
- **Practice address phone:** (860) 663-3634
- **Practice address fax:** (860) 663-3795
- **Mailing address:** PO BOX 207, DURHAM, CT 06422-0207
- **Mailing address phone:** (860) 663-3634
- **Mailing address fax:** (860) 663-3795

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | E5455 | CT | Yes |

## Other

- **Enumeration date:** 05/26/2006
- **Last updated:** 02/06/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004243789 | — | CT |
| 01 | — | 506411 | CONNECTICARE | CT |
| 01 | — | 710C038B1CT01 | ANTHEM BLUE CROSS | CT |
| 01 | — | CW0088 | HEALTHNET | CT |