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STATE OF CONNECTICUT NPI 1871524678


NPI Information

NPI: 1871524678
Provider Name: STATE OF CONNECTICUT

Doing Business As: SOUTHBURY TRAINING FIRE DEPARTMENT

Classification: Ambulance - 341600000X
Entity Type: Organization

CLIA Number: 07D2113469

Address:
ROUTE 172
DEPT OF MENTAL RETARDATION: SOUTHBURY TRAINING SCHOOL
SOUTHBURY, CT
ZIP 06488
Phone: (203) 586-2621
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STATE OF CONNECTICUT is an ambulance in Southbury, CT. The provider is an emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). STATE OF CONNECTICUT NPI is 1871524678. The provider is registered as an organization entity type.
The provider Is Doing Business As Southbury Training Fire Department.

The provider's business location address is:

ROUTE 172
DEPT OF MENTAL RETARDATION: SOUTHBURY TRAINING SCHOOL
SOUTHBURY, CT
ZIP 06488-901
Phone: (203) 586-2621
Fax: (203) 586-2701

The provider's authorized official is Kathryn M Hanewicz .
The authorized official title is Assistant Regional Director and has the following contact phone number (203) 586-2518.

The CLIA number assigned to this NPI record is 07D2113469 - ambulance with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/6/2006 and was last updated on 9/27/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1341600000XAmbulanceYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004205218MEDICAIDCONNECTICUT

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.