Organization
LAWRENCE AND MEMORIAL HOSPITAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON KERSEY (EMS COORDINATOR)
(860) 444-5764
Entity
Organization
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(860) 444-5164
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114428400
US DEPT OF LABOR
CT
01
—
710C095P1CT01
ANTHEM BLUE CROSS BLUE SHIELD
CT
01
—
Z09781
HEALTHNET
CT
Enumeration date
11/02/2009
Last updated
08/07/2023
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