Provider Demographics
NPI:1114002615
Name:MIDDLESEX HOSPITAL PARAMEDICS
Entity Type:Organization
Organization Name:MIDDLESEX HOSPITAL PARAMEDICS
Other - Org Name:MIDDLESEX HEALTH SYSTEMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, EMERGENCY MEDICAL SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:
Authorized Official - Last Name:ROGOFF
Authorized Official - Suffix:
Authorized Official - Credentials:EMT-P, MBA
Authorized Official - Phone:860-344-6081
Mailing Address - Street 1:195 ROUTE 80
Mailing Address - Street 2:C/O SHARED RESPONSE HEALTH SYSTEMS
Mailing Address - City:KILLINGWORTH
Mailing Address - State:CT
Mailing Address - Zip Code:06419-1400
Mailing Address - Country:US
Mailing Address - Phone:860-663-3634
Mailing Address - Fax:860-663-3795
Practice Address - Street 1:28 CRESCENT ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:CT
Practice Address - Zip Code:06457-3654
Practice Address - Country:US
Practice Address - Phone:860-663-3634
Practice Address - Fax:860-663-3795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC083P1341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT764671OtherCONNECTICARE, HMO
CTCT0287OtherHEALTHNET HMO
CTA3159377OtherOXFORD HEALTH PLAN, HMO