MADISON AMBULANCE ASSOCIATION INC NPI 1437144284

NPI Information

NPI: 1437144284
Provider Name: MADISON AMBULANCE ASSOCIATION INC
Classification: Ambulance - 3416L0300X
Entity Type: Organization

Specialization: Land Transport

CLIA Number: 07D2123669

Address:
9 OLD ROUTE 79
MADISON, CT
ZIP 06443
Phone: (203) 245-9821
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MADISON AMBULANCE ASSOCIATION INC is a land transport ambulance in Madison, CT. MADISON AMBULANCE ASSOCIATION INC NPI is 1437144284. The provider is registered as an organization entity type.

The provider's business location address is:

9 OLD ROUTE 79
MADISON, CT
ZIP 06443-604
Phone: (203) 245-9821

The provider's authorized official is Samuel E. Deburra .
The authorized official title is President and has the following contact phone number (203) 245-5617.

The CLIA number assigned to this NPI record is 07D2123669 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2005 and was last updated on 2/16/2018.

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			No
2	3416L0300X	Ambulance	Land Transport	C076P1	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	004084406	MEDICAID	CONNECTICUT
2	CT0849	OTHER		HEALTHNET
3	590003585	OTHER		RAILROAD MEDICARE
4	710C076P1CT01	OTHER		BLUE CROSS/BLUE SHIELD

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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