Stafford Ambulance Association Inc.
Organization Active NPI Ambulance · Stafford Springs, CT
NPI 1215929401 · NPPES record last updated Apr 18, 2013
Key facts
- NPI
- 1215929401
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- C134B1 (CT)
- Legal business name
- STAFFORD AMBULANCE ASSOCIATION INC.
- Practice address
- 27 Willington Ave
Stafford Springs, CT 06076-1620 - Phone
- (860) 668-3885
- Fax
- (860) 668-3885
- NPI assigned
- Aug 16, 2005
- Organization subpart
- No
Authorized official
- Name
- Mr. Alexander Moore
- Title
- Ambulance Chief
- Phone
- (860) 684-5364
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060411000704 | CT | Part B Supplier - Ambulance Service Supplier | 6800805318 | Practice locations: Stafford Springs, CT |
National Provider Directory
Locations
27 Willington Ave
Stafford Springs, CT 06076
Phone (860) 668-3885
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | C134B1 | CT | Yes |
Addresses
Primary practice location
27 Willington Ave
Stafford Springs, CT 06076-1620
Mailing address
PO Box 204
West Suffield, CT 06093-0204
Phone (860) 668-3885
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 105028000 | Other | DEPT OF LABOR | |
| 710C134A2CT01 | Other | CT | ANTHEM BLUE CROSS BS |
| 004142890 | Medicaid | CT | |
| 00414289000 | Other | BLUE CARE FAMILY | |
| 784671 | Other | CONNECTICARE |
Other providers in Stafford Springs, CT
- Crystal Shaw
- Deborah Shearer
- Desh R Sindwani
- Deanna Marie Soja
- Somers Anesthesiology Associates
- Stafford Dental Associates LLC
- Stafford Family Chiropractic, LLC
- Stafford Family Services
- Stafford Public Schools
- Stafford Springs CT SNF LLC
All providers in Stafford Springs, CT · Ambulance in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.