Organization
LEBANON VOLUNTEER FIRE DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY PETRIE (CAPTAIN)
(860) 642-7546
Entity
Organization
Contact information
Practice address
23 GOSHEN HILL RD, LEBANON, CT 06249-1710
(860) 642-7546
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
—
004239952
—
CT
01
—
710C071B1CT01
BLUE CROSS/BLUE SHIELD
—
01
—
CU6728
HEALTHNET
—
Enumeration date
09/19/2005
Last updated
09/17/2010
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