Organization
AMERICAN LEGION AMBULANCE FUND INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY T GENTILE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
298 MAIN ST, MOOSUP, CT 06354-1016
(860) 564-7410
(860) 564-3386
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
(860) 563-3403
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C109B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004142733
—
CT
01
—
590009612
RAILROAD MEDICARE
—
Enumeration date
10/11/2005
Last updated
09/04/2008
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