Provider Demographics
NPI:1073534335
Name:GREENWICH EMERGENCY MEDICAL SERVICE, INC.
Entity Type:Organization
Organization Name:GREENWICH EMERGENCY MEDICAL SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FISCAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-637-7505
Mailing Address - Street 1:1111 E PUTNAM AVE
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CT
Mailing Address - Zip Code:06878-1335
Mailing Address - Country:US
Mailing Address - Phone:203-637-7505
Mailing Address - Fax:203-637-1762
Practice Address - Street 1:1111 E PUTNAM AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CT
Practice Address - Zip Code:06878-1335
Practice Address - Country:US
Practice Address - Phone:203-637-7505
Practice Address - Fax:203-637-1762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC057P1341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTA644995OtherOXFORD
CT621171OtherCONNECTICARE
CT0490917OtherCIGNA
CT0095353OtherAETNA
CTCT0117OtherHEALTHNET