Organization
EAST GRANBY AMBULANCE ASSN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DELORES LINDQUIST (PRESIDENT)
(860) 653-4165
Entity
Organization
Contact information
Practice address
6 MEMORIAL DR, EAST GRANBY, CT 06026-9632
(860) 653-4165
Mailing address
PO BOX 282, EAST GRANBY, CT 06026-0282
(860) 668-3885
(860) 668-3885
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C040B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004186509
—
CT
01
—
00418650900
BLUE CARE FAMILY
—
01
—
356979800
DEPT OF LABOR
—
01
—
701985
CONNECTICARE
—
01
—
710C040B1CT01
ANTHEM BLUECROSSBLUESHIEL
CT
01
—
P00006599
RAILROAD MEDICARE
—
Enumeration date
08/16/2005
Last updated
08/13/2013
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