Provider Demographics
NPI:1588664403
Name:CANTERBURY VOLUNTEER FIRE COMPANY INC
Entity Type:Organization
Organization Name:CANTERBURY VOLUNTEER FIRE COMPANY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMS CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAZZARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-546-9807
Mailing Address - Street 1:269 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CROMWELL
Mailing Address - State:CT
Mailing Address - Zip Code:06416-2302
Mailing Address - Country:US
Mailing Address - Phone:860-638-1800
Mailing Address - Fax:860-638-1802
Practice Address - Street 1:155 WESTMINSTER RD
Practice Address - Street 2:
Practice Address - City:CANTERBURY
Practice Address - State:CT
Practice Address - Zip Code:06331-1432
Practice Address - Country:US
Practice Address - Phone:860-546-9807
Practice Address - Fax:860-303-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004237170Medicaid
CT004237170OtherCOMMUNITY HEALTH
590015567OtherRAILROAD MEDICARE
CT710C022A2CT01OtherBLUE CROSS/BLUE SHIELD
CT004237170OtherCOMMUNITY HEALTH
CT004237170Medicaid
CT710C022A2CT01OtherBLUE CROSS/BLUE SHIELD