Deep River Ambulance Association, Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

E3581 Issued in CT

Legal business name

DEEP RIVER AMBULANCE ASSOCIATION, INC

Practice address

284 W Elm St
Deep River, CT 06417-1617

Phone

(860) 663-3634

Fax

(860) 663-3795

NPI assigned

Oct 10, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandra Castlevetro

Title

Billing Manager

Phone

(860) 663-3634

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104913086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 274",
            "city": "DEEP RIVER",
            "state": "CT",
            "postal_code": "064170274",
            "telephone_number": "860-663-3634",
            "fax_number": "860-663-3795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 W ELM ST",
            "city": "DEEP RIVER",
            "state": "CT",
            "postal_code": "064171617",
            "telephone_number": "860-663-3634",
            "fax_number": "860-663-3795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEP RIVER AMBULANCE ASSOCIATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CASTLEVETRO",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "860-663-3634"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "CT",
            "license": "E3581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "N291876",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "495263",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "CT8252",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Woodall Bourgeois
• Butterfly Haven
• Andrea Simandy Chiappa, LPC
• Chiropractical Solutions LLC
• Richard R Daniels Jr., PHARMD
• Deep River Board of Education
• Deep River Family Dental PLLC
• Deep River Wellness
• Sandra Anne Ely, APRN
• Susan C. Fratoni, RPH

• Ambulance in Deep River, CT
• Providers in Deep River, CT by specialty
• Ambulance in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.