Organization
TOWN OF WESTPORT
Active
Other names
Town of Westport EMS
Organization subpart
No
Provider details
NPI number
Authorized official
MARC HARTOG (BILLING COORDINATOR)
(203) 341-6056
Entity
Organization
Contact information
Practice address
50 JESUP RD, WESTPORT, CT 06880-4309
(203) 341-6056
(203) 454-6157
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
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004091906
—
CT
01
—
710C158A2CT01
BLUE CROSS/BLUE SHIELD
—
01
—
CV0851
HEALTHNET
—
Enumeration date
02/09/2006
Last updated
09/22/2010
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