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Organization
EAST HADDAM AMBULANCE ASSOC INC
Active
Organization
EAST HADDAM AMBULANCE ASSOC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY S QUINN (SERVICE ADMIN.)
(860) 873-5058
Entity
Organization
Contact information
Practice address
440 TOWN ST., EAST HADDAM, CT 06423
(860) 873-2838
(860) 446-0130
Mailing address
195 ROUTE 80, KILLINGWORTH, CT 06419-1400
(860) 873-2838
(860) 828-2144
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004010187
—
CT
01
—
590014967
RAILROAD MEDICARE
—
01
—
710C041A2CT01
BLUE CROSS/BLUE SHIELD
—
Enumeration date
07/22/2005
Last updated
04/04/2013
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