Healthcare Provider Details

I. General information

NPI: 1942313440
Provider Name (Legal Business Name): TOWN OF ENFIELD BOARD OF EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 07/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1296 ENFIELD ST
ENFIELD CT
06082-4912
US

IV. Provider business mailing address

8 TURCOTTE MEMORIAL DR C/O COMSTAR
ROWLEY MA
01969-1706
US

V. Phone/Fax

Practice location:
  • Phone: 860-253-5243
  • Fax:
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 NumberC049P1
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberC049P1
License Number StateCT

VIII. Authorized Official

Name: GARY WIEMOKLY
Title or Position: EMS DIRECTOR
Credential:
Phone: 860-253-2543