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General NPI Number Information
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NPI Number | 1033101241
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Entity Type | Organization
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Legal Business Name | SUFFIELD VOLUNTEER AMBULANCE ASSOCIATION INC
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 205 BRIDGE ST
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City | SUFFIELD
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State | CT
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Zip | 06078-2105
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Country | US
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Telephone | 860-668-3881
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 62
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City | W SUFFIELD
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State | CT
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Zip | 06093-0062
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Country | US
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Telephone | 860-668-3885
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Fax | 860-668-3885
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Authorized Official
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Title or Position | AMBULANCE CHIEF
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Name | MR. ARTHUR GROUX
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Credential |
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Telephone | 860-668-3881
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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 | C139I1
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License Number State | CT
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