Bristol Hospital EMS, LLC

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

BRISTOL HOSPITAL EMS, LLC

Practice address

371 Terryville Ave
Bristol, CT 06010-4029

Phone

(860) 585-3679

Fax

(860) 585-3110

NPI assigned

Nov 3, 2005

Organization subpart

No

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

Authorized official

Name

Timothy A Ajayi, CPA

Title

Cfo

Phone

(860) 585-3024

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1184615684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371 TERRYVILLE AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104029",
            "telephone_number": "860-585-3157",
            "fax_number": "860-585-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371 TERRYVILLE AVE",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104029",
            "telephone_number": "860-585-3679",
            "fax_number": "860-585-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTOL HOSPITAL EMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-03",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "AJAYI",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "860-585-3024",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "CT",
            "license": "L017P2",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004201117",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bristol Health Pharmacy, LLC
• Bristol Hearing AIDS, LLC
• Bristol Home Care and Hospice Agency Inc
• Bristol Home Care and Hospice Agency Inc
• Bristol Hospital Clinicians, P.C.
• Bristol Hospital Inc
• Bristol Hospital Incorporated
• Bristol Hospital Incorporated
• Bristol Hospital Incorporated
• Bristol Hospital Multi Specialty Group, Inc

• All providers in Bristol, CT
• Land Ambulance in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.