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General NPI Number Information
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NPI Number | 1922008770
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Entity Type | Organization
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Legal Business Name | GLASTONBURY VOLUNTEER AMBULANCE ASSOCIATION INC
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 2112 MAIN ST
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City | GLASTONBURY
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State | CT
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Zip | 06033-2285
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Country | US
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Telephone | 860-633-6554
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Fax | 860-657-1443
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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 | 860-257-7080
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Fax | 860-721-6362
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | JENNIFER R DOW
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Credential |
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Telephone | 800-336-6402
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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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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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