Organization
GRANBY AMBULANCE ASSOCIATION, INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI DIBATTISTO (PRESTIDENT)
(860) 653-6535
Entity
Organization
Contact information
Practice address
1 PEGVILLE ROAD, GRANBY, CT 06035-1615
(860) 653-6535
(888) 965-4620
Mailing address
1 PEGVILLE ROAD, GRANBY, CT 06035-1615
(860) 653-6535
(888) 965-4620
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C056B1
CT
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004149739
—
CT
01
—
00414973900
BLUE CARE FAMILY
—
01
—
204062000
DEPT OF LABOR
—
01
—
590010949
RAILROAD MEDICARE
—
01
—
706607
CONNECTICARE
—
01
—
710C056B1CT01
ANTHEM BCBS
CT
Enumeration date
08/15/2005
Last updated
06/04/2020
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