Active NPI
The Bethany Volunteer Firemens Association Incorporated
- Ambulance
- Bethany, CT
National Provider Identifier
1679561120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- C008B1
- Legal business name
- THE BETHANY VOLUNTEER FIREMENS ASSOCIATION INCORPORATED
- Practice address
- 765 Amity Rd
Bethany, CT 06524-3028 - Phone
- (203) 393-2799
- Fax
- (203) 234-0776
- NPI assigned
- Oct 10, 2005
- Last updated
- Nov 13, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steven Kirschbaum
- Title
- Director
- Phone
- (203) 747-4317
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | C008B1 | CT | Primary |
Addresses
Primary practice location
765 Amity Rd
Bethany, CT 06524-3028
Mailing address
765 Amity Rd
Bethany, CT 06524-3028
Phone (203) 393-2799
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 590012110 | Other | RAILROAD MEDICARE | |
| 4225761 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120119000752 | CT | Part B Supplier - Ambulance Service Supplier | 6002083847 | Practice locations: Bethany, CT |
National Provider Directory
National Provider DirectoryLocations
460 Amity Rd
Bethany, CT 06524
Phone (203) 393-2799
765 Amity Rd
Bethany, CT 06524
Phone (203) 343-2799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128902400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731456000000",
"number": "1679561120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "765 AMITY RD",
"city": "BETHANY",
"state": "CT",
"postal_code": "065243028",
"telephone_number": "203-393-2799",
"fax_number": "203-234-0776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "765 AMITY RD",
"city": "BETHANY",
"state": "CT",
"postal_code": "065243028",
"telephone_number": "203-393-2799",
"fax_number": "203-234-0776"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE BETHANY VOLUNTEER FIREMENS ASSOCIATION INCORPORATED",
"organizational_subpart": "NO",
"enumeration_date": "2005-10-10",
"last_updated": "2024-11-13",
"certification_date": "2024-11-13",
"status": "A",
"authorized_official_last_name": "KIRSCHBAUM",
"authorized_official_first_name": "STEVEN",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "203-747-4317"
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "CT",
"license": "C008B1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "590012110",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4225761",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bethany, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.