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General NPI Number Information
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NPI Number | 1013918408
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Entity Type | Organization
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Legal Business Name | KB AMBULANCE CORPS, INC.
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Dates
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Enumeration Date | 08/09/2005
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Last Update Date | 05/23/2011
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Provider Practice Location Address
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Address Line | 294 WESTCOTT ROAD
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City | DANIELSON
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State | CT
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Zip | 06239-0209
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Country | US
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Telephone | 860-774-7625
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Fax | 860-779-2069
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Provider Business Mailing Address
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Address Line | PO BOX 209
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City | DANIELSON
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State | CT
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Zip | 06239-0209
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Country | US
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Telephone | 860-774-7625
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Fax | 860-779-2069
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GEORGE RANDOLPH DAGGETT
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Credential |
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Telephone | 860-774-7625
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | C069B1
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License Number State | CT
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