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Organization

SOUTH WINDSOR AMBULATORY CARE CTR INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. BARBARA M PETRONE RTR (OFFICE MANAGER)
(860) 644-3491
Entity
Organization

Contact information

Practice address
2800 TAMARACK AVENUE, SUITE 105, SOUTH WINDSOR, CT 06074-5539
(860) 644-3491
(860) 644-5744
Mailing address
PO BOX 510, SOUTH WINDSOR, CT 06074-0510
(860) 644-3491
(860) 644-5744

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
024303
CT
261QU0200X
Urgent Care Clinic/Center
Primary
24303
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004263612
CT
01
010024303CT01
BLUE SHIELD OF CT
CT
01
0V0438
HEALTHNET
CT
01
1751515
UNITED HEALTH CARE
GA
01
427750
TUFTS
MA
01
514837
AETNA
TX
01
704554
CONNECTICARE
CT
01
7294618
CIGNA
PA
01
80705
GREAT WEST
CT
01
P3592661
OXFORD
CT
Enumeration date
07/14/2006
Last updated
05/19/2008
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