Organization
TOWN OF SOMERS
Active
Other names
Somers Fire Dept Ambulance
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MARINACCIO (CFO)
(860) 763-8200
Entity
Organization
Contact information
Practice address
400 MAIN ST, SOMERS, CT 06071-1918
(860) 749-7626
Mailing address
PO BOX 98, SOMERS, CT 06071-0098
(860) 668-3885
(860) 668-3885
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
C129B1
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004188969
—
CT
01
—
201064700
DEPT OF LABOR
—
01
—
710C129B1CT01
ANTHEM BCBS
—
01
—
768025
CONNECTICARE
—
01
—
P00134993
RAILROAD MEDICARE
—
Enumeration date
08/16/2005
Last updated
12/04/2014
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