Organization
STAFFORD AMBULANCE ASSOCIATION INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEXANDER MOORE (AMBULANCE CHIEF)
(860) 684-5364
Entity
Organization
Contact information
Practice address
27 WILLINGTON AVE, STAFFORD SPRINGS, CT 06076-1620
(860) 668-3885
(860) 668-3885
Mailing address
PO BOX 204, WEST SUFFIELD, CT 06093-0204
(860) 668-3885
(860) 668-3885
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C134B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004142890
—
CT
01
—
00414289000
BLUE CARE FAMILY
—
01
—
105028000
DEPT OF LABOR
—
01
—
710C134A2CT01
ANTHEM BLUE CROSS BS
CT
01
—
784671
CONNECTICARE
—
Enumeration date
08/16/2005
Last updated
04/18/2013
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