| Organization Name: | ELLINGTON VOLUNTEER AMB |
| NPI Number: | 1659369932 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER M LIZOTTE (AUTHORIZED AGENT) |
| Mailing Address: | 41 Maple St Ellington |
| State: | CT US |
| Postal Code: | 060293333 |
| Phone Number: | 8608703170 |
| Fax Number: | 8608703173 |
| NPI Enumeration Date: | 10/11/2005 |
| NPI Last Update Date: | 06/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | C048B1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |