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General NPI Number Information
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NPI Number | 1386716439
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Entity Type | Organization
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Legal Business Name | PUTNAM EMS AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 11/14/2006
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Last Update Date | 09/04/2014
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Provider Practice Location Address
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Address Line | 191 CHURCH STREET
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City | PUTNAM
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State | CT
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Zip | 06260
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Country | US
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Telephone | 860-779-7209
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Fax | 860-779-7210
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Provider Business Mailing Address
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Address Line | 269 MAIN ST
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City | CROMWELL
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State | CT
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Zip | 06416-2361
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Country | US
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Telephone | 860-638-1818
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Fax | 860-638-1802
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWIN C HIGGINS III
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Credential |
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Telephone | 860-928-6549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | C116B1
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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