Organization
THE LISBON FIRE DEPARTMENT INCORPORATED
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
7 NEWENT RD, LISBON, CT 06351-2938
(860) 376-2558
(860) 376-0493
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
C073B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004245173
—
CT
01
—
P00110169
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
01/29/2018
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