Healthcare Provider Details

I. General information

NPI: 1134223837
Provider Name (Legal Business Name): CITY OF MERIDEN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 MILLER ST
MERIDEN CT
06450-4256
US

IV. Provider business mailing address

165 MILLER ST
MERIDEN CT
06450-4256
US

V. Phone/Fax

Practice location:
  • Phone: 203-630-4229
  • Fax: 203-639-0039
Mailing address:
  • Phone: 203-630-4229
  • Fax: 203-639-0039

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number0012
License Number StateCT

VIII. Authorized Official

Name: MS. BETH VUMBACO
Title or Position: HEALTH & HUMAN SERVICES DIRECTOR
Credential:
Phone: 203-630-4221