# AMERICAN LEGION COMMUNITY AMBULANCE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GRISWOLD AMERICAN LEGION AMBULANCE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992705743
- **Authorized official:** BILL CZMYR (PRESIDENT)
- **Authorized official phone:** (860) 376-3080

## Contact information

- **Practice address:** 20 SOULE ST, JEWETT CITY, CT 06351-2217
- **Practice address phone:** (860) 376-3080
- **Practice address fax:** (860) 376-7703
- **Mailing address:** 269 MAIN ST, CROMWELL, CT 06416-2302
- **Mailing address phone:** (860) 638-1800
- **Mailing address fax:** (860) 638-1802

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3416L0300X | Land Ambulance | — | NULL | Yes |

## Other

- **Enumeration date:** 07/22/2005
- **Last updated:** 09/22/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004110144 | — | CT |
| 01 | — | 590008427 | RAILROAD MEDICARE | — |
| 01 | — | 710C058B1CT01 | BLUE CROSS/BLUE SHIELD | — |
| 01 | — | Z09748 | HEALTHNET | — |