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NPI Code Detail

MEDICARE: CONNECTICUT HANDIVAN, INC.

MEDICARE: CONNECTICUT HANDIVAN, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1343900000XNon-emergency Medical Transport (VAN)2601CT

General Provider Information

NPI Number : 1639356298
Entity Type Code : Organization
Provider Name (Legal Business Name) : CONNECTICUT HANDIVAN, INC.
Provider Business Mailing Address
First Line : 208 QUINNIPIAC AVE
Second Line :
City : NORTH HAVEN
State : CT
Zip : 06473-3626
Country : US
Telephone Number : 203-562-1760
Fax Number :
Provider Business Practice Location Address
First Line : 208 QUINNIPIAC AVE
Second Line :
City : NORTH HAVEN
State : CT
Zip : 06473-3626
Country : US
Telephone Number : 203-562-1760
Fax Number :
Authorized Official
Title or Position : VICE PRESIDENT
Name : MARK J PANICO
Credential : MBA
Telephone Number : 203-562-1760
Provider Enumeration Date : 01/25/2008
Last Update Date : 01/25/2008

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Directions to “CONNECTICUT HANDIVAN, INC. ” Practice Location

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