Organization
DURHAM VOLUNTEER AMBULANCE CORPS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS WIMLER (CHIEF OF SERVICE)
(860) 349-9966
Entity
Organization
Contact information
Practice address
205 MAIN ST, DURHAM, CT 06422-2108
(860) 663-3634
(860) 663-3795
Mailing address
PO BOX 207, DURHAM, CT 06422-0207
(860) 663-3634
(860) 663-3795
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
E5455
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004243789
—
CT
01
—
506411
CONNECTICARE
CT
01
—
710C038B1CT01
ANTHEM BLUE CROSS
CT
01
—
CW0088
HEALTHNET
CT
Enumeration date
05/26/2006
Last updated
02/06/2013
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