Lebanon Volunteer Fire Department

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

LEBANON VOLUNTEER FIRE DEPARTMENT

Practice address

23 Goshen Hill Rd
Lebanon, CT 06249-1710

Phone

(860) 642-7546

NPI assigned

Sep 19, 2005

Organization subpart

No

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

Authorized official

Name

Betsy Petrie

Title

Captain

Phone

(860) 642-7546

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Elliott, APRN, CRNA

  • Certified Registered Nurse Anesthetist
  • East Hartford, CT
  • NPI 1942261029
  NPD

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284681600000",
    "number": "1295720043",
    "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": "23 GOSHEN HILL RD",
            "city": "LEBANON",
            "state": "CT",
            "postal_code": "062491710",
            "telephone_number": "860-642-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEBANON VOLUNTEER FIRE DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2010-09-17",
        "status": "A",
        "authorized_official_last_name": "PETRIE",
        "authorized_official_first_name": "BETSY",
        "authorized_official_title_or_position": "CAPTAIN",
        "authorized_official_telephone_number": "860-642-7546"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "CU6728",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004239952",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "710C071B1CT01",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Alice Gendreau, LMT
• Jennifer Irene Haddad, LO
• Nusie M Halpine, LCSW
• Lillian Julian, LMSW
• Lebanon Board of Education
• Jeffrey Mitchell Levine, PSY.D.
• Maple Stone Counseling, LLC
• Heather Massicotte
• Kaitlyn A Murphy, M.ED. M.S. BCBA, LBA
• Thomas E Pawlowski

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.