Provider Demographics
NPI:1801856612
Name:WILTON LYNDEBOROUGH VOLUNTEER AMBULANCE
Entity Type:Organization
Organization Name:WILTON LYNDEBOROUGH VOLUNTEER AMBULANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCENTEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-654-2222
Mailing Address - Street 1:8 TURCOTTE MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ROWLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01969-1706
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:
Practice Address - Street 1:404 FOREST RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:NH
Practice Address - Zip Code:03086-5129
Practice Address - Country:US
Practice Address - Phone:603-654-2222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0121341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAZD7797OtherBLUE CROSS BLUE SHIELD
590013265OtherRR MEDICARE
701752OtherHARVARD PILGRIM
NH7106327Y0NH01OtherANTHEM BLUE CROSS
803914OtherTUFTS HEALTH PLAN
NH30009515Medicaid
NH30009515Medicaid
NH7106327Y0NH01OtherANTHEM BLUE CROSS