Healthcare Provider Details

I. General information

NPI: 1134235104
Provider Name (Legal Business Name): CLINTON VOLUNTEER FIRE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 E MAIN ST
CLINTON CT
06413-2049
US

IV. Provider business mailing address

35 E MAIN ST
CLINTON CT
06413-2049
US

V. Phone/Fax

Practice location:
  • Phone: 860-669-8131
  • Fax: 860-669-7650
Mailing address:
  • Phone: 860-669-8131
  • Fax: 860-669-7650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberCO27B1
License Number StateCT

VIII. Authorized Official

Name: JEFFREY A HESER
Title or Position: CHIEF
Credential:
Phone: 860-669-8131