BRISTOL HOSPITAL EMS LLC NPI 1184615684

NPI Information

NPI: 1184615684
Provider Name: BRISTOL HOSPITAL EMS, LLC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 07D2141644

Address:
371 TERRYVILLE AVE
BRISTOL, CT
ZIP 06010
Phone: (860) 585-3679
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BRISTOL HOSPITAL EMS, LLC is a land transport ambulance in Bristol, CT. BRISTOL HOSPITAL EMS, LLC NPI is 1184615684. The provider is registered as an organization entity type.

The provider's business location address is:

371 TERRYVILLE AVE
BRISTOL, CT
ZIP 06010-029
Phone: (860) 585-3679
Fax: (860) 585-3110

The provider's authorized official is Timothy A Ajayi .
The authorized official title is Cfo and has the following contact phone number (860) 585-3024.

The CLIA number assigned to this NPI record is 07D2141644 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 10/10/2023.

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	341600000X	Ambulance		L017P2	CONNECTICUT	No
2	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	004201117	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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