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General NPI Number Information
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NPI Number | 1114002615
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Entity Type | Organization
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Legal Business Name | MIDDLESEX HOSPITAL PARAMEDICS
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 28 CRESCENT ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-3654
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Country | US
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Telephone | 860-663-3634
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Fax | 860-663-3795
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Provider Business Mailing Address
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Address Line | 195 ROUTE 80 C/O SHARED RESPONSE HEALTH SYSTEMS
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City | KILLINGWORTH
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State | CT
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Zip | 06419-1400
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Country | US
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Telephone | 860-663-3634
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Fax | 860-663-3795
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Authorized Official
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Title or Position | MANAGER, EMERGENCY MEDICAL SERVICES
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Name | CRAIG ROGOFF
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Credential | EMT-P, MBA
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Telephone | 860-344-6081
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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 | C083P1
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License Number State | CT
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