EAST LYME AMBULANCE FUND INC NPI 1851391601

NPI Information

NPI: 1851391601
Provider Name: EAST LYME AMBULANCE FUND INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 07D2113889

Address:
8 GRAND ST
NIANTIC, CT
ZIP 06357
Phone: (860) 739-3449
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EAST LYME AMBULANCE FUND INC is a land transport ambulance in Niantic, CT. EAST LYME AMBULANCE FUND INC NPI is 1851391601. The provider is registered as an organization entity type.

The provider's business location address is:

8 GRAND ST
NIANTIC, CT
ZIP 06357-204
Phone: (860) 739-3449
Fax: (860) 739-5268

The provider's authorized official is Charles Holyfield .
The authorized official title is President and has the following contact phone number (860) 739-3449.

The CLIA number assigned to this NPI record is 07D2113889 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/22/2005 and was last updated on 9/17/2010.

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			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	710C045A2CT01	OTHER		BLUE CROSS/BLUE SHIELD
2	CU8738	OTHER		HEALTHNET
3	590000192	MEDICARE UPIN	CONNECTICUT
4	004195807	MEDICAID	CONNECTICUT

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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