Provider Demographics
NPI:1912446956
Name:TOWN OF COVENTRY
Entity Type:Organization
Organization Name:TOWN OF COVENTRY
Other - Org Name:TOWN OF COVENTRY FIRE/EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TOWN MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:ELSESSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-742-6324
Mailing Address - Street 1:1712 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COVENTRY
Mailing Address - State:CT
Mailing Address - Zip Code:06238-3615
Mailing Address - Country:US
Mailing Address - Phone:800-488-4351
Mailing Address - Fax:978-356-2721
Practice Address - Street 1:1712 MAIN ST
Practice Address - Street 2:
Practice Address - City:COVENTRY
Practice Address - State:CT
Practice Address - Zip Code:06238-3615
Practice Address - Country:US
Practice Address - Phone:860-531-2563
Practice Address - Fax:860-742-8911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC-032B2341600000X, 3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance