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OLD MYSTIC FIRE DISTRICT NPI 1073981536


NPI Information

NPI: 1073981536
Provider Name: OLD MYSTIC FIRE DISTRICT

Other Name: OLD MYSTIC FIRE DEPARTMENT

Classification: Emergency Medical Technician, Basic - 146N00000X
Entity Type: Organization

CLIA Number: 07D2114176

Address:
295 COW HILL RD
MYSTIC, CT
ZIP 06355
Phone: (860) 536-2220
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OLD MYSTIC FIRE DISTRICT is an emergency medical technician basic in Mystic, CT. The provider is a Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. OLD MYSTIC FIRE DISTRICT NPI is 1073981536. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Old Mystic Fire Department.

The provider's business location address is:

295 COW HILL RD
MYSTIC, CT
ZIP 06355-407
Phone: (860) 536-2220
Fax: (860) 536-7811

The provider's authorized official is Kenneth W. Richards .
The authorized official title is Fire Chief/fire Marshal and has the following contact phone number (860) 536-2220.

The CLIA number assigned to this NPI record is 07D2114176 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/14/2015 and was last updated on 9/14/2015.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1146N00000XEmergency Medical Technician, BasicYes

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: 11/14/2023

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