=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831227230
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NORTH CANAAN VOLUNTEER AMBULANCE CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 04/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 MAIN STREET
-----------------------------------------------------
City | CANAAN
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06018-0178
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-824-9986
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 195 ROUTE 80
-----------------------------------------------------
City | KILLINGWORTH
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06419-1400
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-452-4500
-----------------------------------------------------
Fax | 860-638-1802
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TREASURER
-----------------------------------------------------
Name | EMILY MINACCI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 860-248-1106
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | C100I1
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------