Organization
POMFRET FIRE DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY T GENTILE (AUTHORIZED AGENT)
(860) 257-9201
Entity
Organization
Contact information
Practice address
67 HAMPTON RD, POMFRET, CT 06258-0306
(860) 974-1508
(860) 974-3639
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(860) 257-9201
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C112B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004250081
—
CT
01
—
P00986248
RAILROAD MEDICARE
CT
Enumeration date
10/26/2005
Last updated
01/06/2012
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