Healthcare Provider Details

I. General information

NPI: 1245228618
Provider Name (Legal Business Name): TOWN OF COLCHESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 07/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 OLD HARTFORD RD
COLCHESTER CT
06415-2736
US

IV. Provider business mailing address

8 TURCOTTE MEMORIAL DR
ROWLEY MA
01969-1706
US

V. Phone/Fax

Practice location:
  • Phone: 860-537-2512
  • Fax: 860-537-3332
Mailing address:
  • Phone: 800-488-4351
  • Fax: 978-356-2721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberC028B1
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: WALTER COX
Title or Position: CHIEF OF SERVICE
Credential:
Phone: 860-537-2512