GARDNER LAKE VOLUNTEER FIRE COMPANY; NPI #1164410601

Contact Information

GARDNER LAKE VOLUNTEER FIRE COMPANY

429 OLD COLCHESTER RD
SALEM, CT 06420-3748

Phone: 860-859-1743
Fax: 860-892-5392
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Ambulance	341600000X	59	Ambulance Service Provider

Indicates primary specialty

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NPI Profile & details for GARDNER LAKE VOLUNTEER FIRE COMPANY

NPI # 1164410601

LBN Legal business name GARDNER LAKE VOLUNTEER FIRE COMPANY

Authorized official MARY GENTILE - (AUTHORIZED AGENT)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/10/2005

Last updated 09/23/2008 - About 18 years ago

Identifiers

CT	License #	C121B1
CT	Medicaid	004211158
CT	Other	P00606334	RAILROAD

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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