Organization
PUTNAM EMS AMBULANCE SERVICE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN C HIGGINS III (PRESIDENT)
(860) 928-6549
Entity
Organization
Contact information
Practice address
191 CHURCH STREET, PUTNAM, CT 06260
(860) 779-7209
(860) 779-7210
Mailing address
269 MAIN ST, CROMWELL, CT 06416-2361
(860) 638-1818
(860) 638-1802
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
C116B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004112877
EDS
—
01
—
710C116B1CT01
ANTHEM BLUE CROSS BLUE SH
—
01
—
802178
COMMUNITY HEALTH NETWORK
—
01
—
CT0370
HEALTHNET
—
Enumeration date
11/14/2006
Last updated
09/04/2014
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