Healthcare Provider Details

I. General information

NPI: 1790609097
Provider Name (Legal Business Name): WESTBROOK CHEMICAL ENGINE COMPANY 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 SOUTH MAIN ST
WESTBROOK CT
06498
US

IV. Provider business mailing address

1163 BOSTON POST RD
WESTBROOK CT
06498-1947
US

V. Phone/Fax

Practice location:
  • Phone: 860-399-9492
  • Fax:
Mailing address:
  • Phone: 860-399-9492
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW B CANOVA
Title or Position: CHIEF OF FIRE DEPARTMENT
Credential:
Phone: 860-662-0611