Organization
MADISON AMBULANCE ASSOCIATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL E. DEBURRA JR. (PRESIDENT)
(203) 245-5617
Entity
Organization
Contact information
Practice address
9 OLD ROUTE 79, MADISON, CT 06443-2604
(203) 245-9821
Mailing address
195 ROUTE 80, KILLINGWORTH, CT 06419-1400
(860) 663-3634
(860) 663-3795
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
C076P1
CT
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004084406
—
CT
01
—
590003585
RAILROAD MEDICARE
—
01
—
710C076P1CT01
BLUE CROSS/BLUE SHIELD
—
01
—
CT0849
HEALTHNET
—
Enumeration date
09/19/2005
Last updated
02/16/2018
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