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General NPI Number Information
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NPI Number | 1790743037
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Entity Type | Organization
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Legal Business Name | BRISTOL-BURLINGTON HEALTH DISTRICT
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 10/22/2013
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Provider Practice Location Address
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Address Line | 240 STAFFORD AVE
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City | BRISTOL
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State | CT
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Zip | 06010-4682
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Country | US
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Telephone | 860-584-7682
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Fax | 860-584-3814
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Provider Business Mailing Address
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Address Line | 240 STAFFORD AVE
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City | BRISTOL
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State | CT
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Zip | 06010-4682
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Country | US
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Telephone | 860-584-7682
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Fax | 860-584-3814
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Authorized Official
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Title or Position | DIRECTOR OF HEALTH
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Name | MR. CHARLES I. MOTES
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Credential | MS, MPH, RS
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Telephone | 860-584-7682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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