Organization
SOUTHBURY AMBULANCE ASSOCIATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY VELTHUIZEN (PRESIDENT)
(203) 262-8082
Entity
Organization
Contact information
Practice address
68 GEORGES HILL RD, SOUTHBURY, CT 06488-2613
(203) 262-8082
(203) 262-8082
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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004205218
—
CT
01
—
710C130A2CT01
BLUE CROSS/BLUE SHIELD
CT
01
—
CV1577
HEALTHNET
—
Enumeration date
02/09/2006
Last updated
03/27/2013
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