Organization
ROY B PETTENGILL AMB ASSOC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI A TARKA (PRESIDENT)
(860) 402-5899
Entity
Organization
Contact information
Practice address
7 HEBRON RD, MARLBOROUGH, CT 06447-1202
(860) 295-6219
(860) 295-0604
Mailing address
PO BOX 165, BRANFORD, CT 06405-0165
(860) 663-3634
(860) 452-4430
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
C079B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004224565
—
CT
Enumeration date
10/10/2005
Last updated
11/04/2025
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