Baltic Fire Engine Company No 1 Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

C133B1 Issued in CT

Legal business name

BALTIC FIRE ENGINE COMPANY NO 1 INC

Practice address

1 Main St
Baltic, CT 06330-1320

Phone

(860) 822-6580

NPI assigned

Feb 14, 2008

Last updated

Jan 8, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Tardif

Title

Chief

Phone

(860) 822-6580

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1202947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262908800000",
    "number": "1285802090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MAIN ST",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162302",
            "telephone_number": "860-638-1800",
            "fax_number": "860-638-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MAIN ST",
            "city": "BALTIC",
            "state": "CT",
            "postal_code": "063301320",
            "telephone_number": "860-822-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIC FIRE ENGINE COMPANY NO 1 INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-14",
        "last_updated": "2010-01-08",
        "status": "A",
        "authorized_official_last_name": "TARDIF",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "860-822-6580",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "CT",
            "license": "C133B1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008001088",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patricia Brennan
• Azriel Ezabeth-Rayne Dziadul
• Kaitlin Ann Gotch, LPC
• Mark J Hamel
• Tamar M Laderman, RN, FNP

• Land Ambulance in Baltic, CT
• Providers in Baltic, CT by specialty
• Land Ambulance in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.