Provider Demographics
NPI:1750457776
Name:PATHWAYS SMBULANCE SERVICE LTD
Entity Type:Organization
Organization Name:PATHWAYS SMBULANCE SERVICE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARROLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-674-1105
Mailing Address - Street 1:PO BOX 3000
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06150-5000
Mailing Address - Country:US
Mailing Address - Phone:888-665-2475
Mailing Address - Fax:508-675-9920
Practice Address - Street 1:4 INDUSTRIAL ROAD
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3589
Practice Address - Country:US
Practice Address - Phone:888-665-2475
Practice Address - Fax:508-675-9920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30053416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAM0041OtherBLUE CROSS BLUE SHIELD
MA1715909Medicaid
MAAM0041OtherBLUE CROSS BLUE SHIELD