Organization
WILLINGTON FIRE DEPT #1
Active
Other names
Willington Fire Dept #1
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD GANTICK (AMBULANCE CHIEF)
(860) 429-0288
Entity
Organization
Contact information
Practice address
426 RIVER RD, WILLINGTON, CT 06279-1310
(860) 429-0288
(860) 487-4545
Mailing address
PO BOX 204, W SUFFIELD, CT 06093
(860) 668-3885
(860) 668-3885
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C160B1
CT
3416L0300X
Land Ambulance
C160B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004119857
—
CT
01
—
5300009415
RAILROAD MEDICARE
—
01
—
590009415
RAILROAD MEDICARE
—
01
—
710C160B1CT01
ANTHEM BLUE CROSS BLUE SH
CT
01
—
756028
CONNECTICARE
—
Enumeration date
10/10/2005
Last updated
08/22/2013
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