AMBULANCE SERVICE OF MANCHESTER LLC NPI 1063529741

NPI Information

NPI: 1063529741
Provider Name: AMBULANCE SERVICE OF MANCHESTER, LLC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 07D2113908

Address:
275 NEW STATE RD
MANCHESTER, CT
ZIP 06042
Phone: (860) 647-9798
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AMBULANCE SERVICE OF MANCHESTER, LLC is a land transport ambulance in Manchester, CT. AMBULANCE SERVICE OF MANCHESTER, LLC NPI is 1063529741. The provider is registered as an organization entity type.

The provider's business location address is:

275 NEW STATE RD
MANCHESTER, CT
ZIP 06042-810
Phone: (860) 647-9798
Fax: (860) 645-8738

The provider's authorized official is Wayne Alfred Wright .
The authorized official title is President and has the following contact phone number (860) 647-9798.

The CLIA number assigned to this NPI record is 07D2113908 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/25/2006 and was last updated on 5/14/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	3416L0300X	Ambulance	Land Transport	L077P2	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	004205052	MEDICAID	CONNECTICUT
2	590000202	MEDICARE ID-TYPE UNSPECIFIED	CONNECTICUT	MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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