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General NPI Number Information
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NPI Number | 1730177171
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Entity Type | Organization
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Legal Business Name | CLINTON VOLUNTEER FIRE DEPT
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 35 E MAIN ST
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City | CLINTON
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State | CT
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Zip | 06413-2049
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Country | US
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Telephone | 860-669-8131
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Fax | 860-664-7650
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Provider Business Mailing Address
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Address Line | PO BOX 290184
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City | WETHERSFIELD
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State | CT
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Zip | 06129-0184
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Country | US
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Telephone | 800-452-8191
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Fax | 860-721-6362
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Authorized Official
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Title or Position | AUTHORIZED AGENT
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Name | MS. HEATHER M LIZOTTE
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Credential |
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Telephone | 800-452-8191
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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 | C027B1
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License Number State | CT
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