MEDICARE: BEACON HOSE COMPANY 1

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
1	341600000X	Ambulance	C006B1	CT

General Provider Information

NPI Number	:	1821098781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEACON HOSE COMPANY 1

Provider Business Mailing Address
First Line	:	35 N MAIN ST
Second Line	:
City	:	BEACON FALLS
State	:	CT
Zip	:	06403-1169
Country	:	US
Telephone Number	:	203-729-1470
Fax Number	:	203-723-2209

Provider Business Practice Location Address
First Line	:	35 N MAIN ST
Second Line	:
City	:	BEACON FALLS
State	:	CT
Zip	:	06403-1169
Country	:	US
Telephone Number	:	203-729-1470
Fax Number	:	203-723-2209

Authorized Official
Title or Position	:	DAYTIME CAPTAIN
Name	:	CONNOR BANKS
Credential	:
Telephone Number	:	203-729-1470

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	07/17/2024

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Directions to “BEACON HOSE COMPANY 1 ” Practice Location

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