Healthcare Provider Details

I. General information

NPI: 1619965167
Provider Name (Legal Business Name): ECHO HOSE HOOK AND LADDER AMBULANCE CORPS., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2005
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEADOW ST
SHELTON CT
06484-2265
US

IV. Provider business mailing address

PO BOX 131
BEACON FALLS CT
06403-0131
US

V. Phone/Fax

Practice location:
  • Phone: 203-924-9211
  • Fax: 203-294-6603
Mailing address:
  • Phone: 203-729-2800
  • Fax: 203-729-2808

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberC126B1
License Number StateCT

VIII. Authorized Official

Name: MS. ROBIN M GREENE
Title or Position: AUTHORIZED AGENT
Credential:
Phone: 203-729-2800