# AETNA AMBULANCE SERVICE, INC

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

## Provider details

- **NPI number:** 1194842781
- **Authorized official:** MR. WAYNE ALFRED WRIGHT (PRESIDENT)
- **Authorized official phone:** (860) 647-9798

## Contact information

- **Practice address:** 140 VAN BLOCK AVE, HARTFORD, CT 06106-2845
- **Practice address phone:** (860) 247-6792
- **Practice address fax:** (860) 724-3384
- **Mailing address:** PO BOX 1150, MANCHESTER, CT 06045-1150
- **Mailing address phone:** (860) 240-7575
- **Mailing address fax:** (860) 643-0759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | L064P2 | CT | Yes |

## Other

- **Enumeration date:** 03/26/2007
- **Last updated:** 05/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004072120 | — | CT |