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Organization

STORM ENGINE CO AMBULANCE CORPS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TOM LENHART (PRESIDENT)
(203) 735-1347
Entity
Organization

Contact information

Practice address
151 OLIVIA ST, DERBY, CT 06418-1712
(203) 735-1347
(203) 735-4873
Mailing address
269 MAIN ST, CROMWELL, CT 06416-2302
(860) 638-1800
(860) 638-1802

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004225290
CT
01
710C037A2CT01
BLUE CROSS/BLUE SHIELD
Enumeration date
02/09/2006
Last updated
08/15/2012
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