MEDICARE: LITCHFIELD AMBULANCE ASSOCIATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	710C074B2CT01	OTHER		BLUE CROSS/BLUE SHIELD

General Provider Information

NPI Number	:	1801881651
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LITCHFIELD AMBULANCE ASSOCIATION INC

Provider Business Mailing Address
First Line	:	195 ROUTE 80
Second Line	:
City	:	KILLINGWORTH
State	:	CT
Zip	:	06419-1400
Country	:	US
Telephone Number	:	860-663-3634
Fax Number	:	860-663-3634

Provider Business Practice Location Address
First Line	:	11 EAST ST
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-3601
Country	:	US
Telephone Number	:	860-567-9132
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOHN JOSEPH PUDLINSKI
Credential	:
Telephone Number	:	860-567-0127

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	05/17/2025

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Directions to “LITCHFIELD AMBULANCE ASSOCIATION INC ” Practice Location

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