East Granby Ambulance Assn

Primary specialty

AmbulanceTaxonomy code 341600000X

License

C040B1 Issued in CT

Legal business name

EAST GRANBY AMBULANCE ASSN

Practice address

6 Memorial Dr
East Granby, CT 06026-9632

Phone

(860) 653-4165

NPI assigned

Aug 16, 2005

Last updated

Aug 13, 2013By 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

Ms. Delores Lindquist

Title

President

Phone

(860) 653-4165

Specialties & licenses 1

Addresses

Other identifiers 6

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

{
    "created_epoch": "1124150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1720070915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 282",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060260282",
            "telephone_number": "860-668-3885",
            "fax_number": "860-668-3885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 MEMORIAL DR",
            "city": "EAST GRANBY",
            "state": "CT",
            "postal_code": "060269632",
            "telephone_number": "860-653-4165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST GRANBY AMBULANCE ASSN",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-16",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "LINDQUIST",
        "authorized_official_first_name": "DELORES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-653-4165",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "CT",
            "license": "C040B1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE FAMILY",
            "identifier": "00418650900",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00006599",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004186509",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "701985",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUECROSSBLUESHIEL",
            "identifier": "710C040B1CT01",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF LABOR",
            "identifier": "356979800",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jean Davis
• Kimberly Diane Davis, DO
• Trinity Dejesus
• Steven R Dieterich, MD
• Devon Dusseault, PT, DPT
• East Granby Board of Education
• East Granby Family Practice LLC
• Educational Advancement Associates
• Ellsworth Medical, LLC
• Maureen Elizabeth Emery, LCSW

• Ambulance in East Granby, CT
• Providers in East Granby, CT by specialty
• Ambulance in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.