Organization
WINDSOR LOCKS LIONS CHARITIES INC.
Active
Other names
Windsor Locks Lions Club Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STUART GERES (ADMINISTRATOR COORDINATOR)
(860) 627-1411
Entity
Organization
Contact information
Practice address
401 SPRING ST, WINDSOR LOCKS, CT 06096-1744
(860) 627-1411
Mailing address
PO BOX 105, WINDSOR LOCKS, CT 06096-0105
(860) 668-3885
(860) 668-3885
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C165B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004137619
—
CT
01
—
104753000
DEPT OF LABOR
—
01
—
590008996
RAILROAD MEDICARE
—
01
—
613128
CONNECTICARE
—
01
—
710C165B1CT01
ANTHEM BCBS
CT
Enumeration date
08/16/2005
Last updated
11/29/2017
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