Provider Demographics
NPI:1821128562
Name:SIMSBURY VOLUNTEER AMBULANCE ASSOCIATION, INC
Entity Type:Organization
Organization Name:SIMSBURY VOLUNTEER AMBULANCE ASSOCIATION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DELEHANTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-658-7213
Mailing Address - Street 1:PO BOX 301
Mailing Address - Street 2:
Mailing Address - City:SIMSBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06070-0301
Mailing Address - Country:US
Mailing Address - Phone:860-658-7213
Mailing Address - Fax:860-658-4987
Practice Address - Street 1:4 OLD MILL LANE
Practice Address - Street 2:
Practice Address - City:SIMSBURY
Practice Address - State:CT
Practice Address - Zip Code:06070
Practice Address - Country:US
Practice Address - Phone:860-658-7213
Practice Address - Fax:860-658-4987
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC128P1341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT00414059700OtherBLUECARE