Organization
KB AMBULANCE CORPS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE RANDOLPH DAGGETT (ADMINISTRATOR)
(860) 774-7625
Entity
Organization
Contact information
Practice address
294 WESTCOTT ROAD, DANIELSON, CT 06239-0209
(860) 774-7625
(860) 779-2069
Mailing address
PO BOX 209, DANIELSON, CT 06239-0209
(860) 774-7625
(860) 779-2069
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C069B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004135184
—
CT
01
—
710C069B1CT01
ANTHEM BLUE CROSS BLUE SHIELD
CT
Enumeration date
08/09/2005
Last updated
05/23/2011
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