Organization
GLASTONBURY VOLUNTEER AMBULANCE ASSOCIATION INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER R DOW (AUTHORIZED OFFICIAL)
(800) 336-6402
Entity
Organization
Contact information
Practice address
2112 MAIN ST, GLASTONBURY, CT 06033-2285
(860) 633-6554
(860) 657-1443
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(860) 257-7080
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
3416L0300X
Land Ambulance
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004141470
—
CT
01
—
590000146
MEDICARE
CT
01
—
590009465
RAILROAD MEDICARE
—
01
—
710C054I1CT01
BLUE CROSS/BLUE SHIELD
—
01
—
CT7135
HEALTHNET
—
Enumeration date
07/22/2005
Last updated
02/20/2024
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