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General NPI Number Information
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NPI Number | 1699748871
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Entity Type | Organization
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Legal Business Name | POQUETANUCK VOLUNTEER FIRE DEPARTMENT INC
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 09/21/2010
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Provider Practice Location Address
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Address Line | 87 ROUTE 2A
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City | PRESTON
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State | CT
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Zip | 06365-8538
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Country | US
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Telephone | 860-887-5151
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Fax | 860-823-1929
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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 | 06416-2302
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Country | US
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Telephone | 860-638-1800
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Fax | 860-638-1802
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Authorized Official
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Title or Position | CHIEF
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Name | RUSSELL HOLLAND
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Credential |
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Telephone | 860-887-5151
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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 |
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License Number State |
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