| Organization Name: | OLD LYME SOUTH END VOLUNTEER AMBULANCE |
| NPI Number: | 1437149994 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY T GENTILE (AUTHORIZED AGENT) |
| Mailing Address: | 22 Cross Ln Old Lyme |
| State: | CT US |
| Postal Code: | 063712115 |
| Phone Number: | 8604340089 |
| Fax Number: | 8604348052 |
| NPI Enumeration Date: | 10/26/2005 |
| NPI Last Update Date: | 03/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 341600000X |
| License Number: | C105B1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane). |