MYSTIC RIVER AMBULANCE ASSOCIATION, INC (NPI# 1699760249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699760249 |
| Entity Type | Organization |
| Organization Name | MYSTIC RIVER AMBULANCE ASSOCIATION, INC |
| Practice Address |
237 Sandy Hollow Rd Mystic CT 06355-1617 |
| Mailing Address |
269 Main St Cromwell CT 06416-2302 |
| Practice Telephone | 8605720581 |
| Mailing Telephone | 8606381800 |
| Mailing Fax Number | 8606381802 |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2010-09-22 |
| Authorized Official Name | CHRISTOPHER CLARKIN (PRESIDENT) |
| Authorized Official Telephone | 8605720581 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004116093 | 05 | |
| RAILROAD MEDICARE | 590006767 | 01 | |
| BLUE CROSS/BLUE SHIELD | 710C137B1CT01 | 01 | |
| HEALTHNET | CT0795 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | MYSTIC RIVER AMBULANCE ASSOCIATION, INC | P.o. Box 64, West Mystic, CT 06388 |
| Street Address |
237 SANDY HOLLOW RD |
| City | MYSTIC |
| State | CT |
| Zip Code | 06355-1617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770076069 | Brian Kristofer Owczarski | Physical Therapist | 80 Stonington Rd Ste A-3, Mystic, CT 06355 | 2018-06-11 |
| 1922554120 | Kayla Nickerson Gauthier | Marriage & Family Therapist | 41 Williams Ave, Mystic, CT 06355 | 2016-08-28 |
| 1417351156 | Lisa Pacifico | Physical Therapist | 44 Maritime Dive, Mystic, CT 06355 | 2014-10-09 |
| 1619386539 | Jennifer Rock | Occupational Therapist | 44 Maritime Drive, Pendleton Health and Rehab Center, Mystic, CT 06355 | 2014-08-05 |
| 1346565843 | Karen Lucille Hanscom | Psychologist | 47 Water St. #203, Mystic, CT 06355 | 2010-03-29 |
| 1346415627 | Eldon Richard Kilpatrick | Physical Therapy Assistant | 186 Jerry Browne Rd, Mystic, CT 06355 | 2008-04-28 |
| 1760688931 | Heather Elyse Geyer | Physical Therapist | 2440 Gold Star Hwy Suite 201, Mystic, CT 06355 | 2007-06-25 |
| 1982728754 | Falck Eye Center LLC | Ophthalmology | 35 Washington Street, Mystic, CT 06355 | 2007-03-19 |
| 1881724326 | Richard Irwin Steinberg | Dentist | 117 Cow Hill Road, Mystic, CT 06355 | 2007-03-06 |
| 1992890362 | Coastal Dermatology, P.C. | Dermatology | 55 Willow Street, Mystic, CT 06355 | 2006-10-03 |
| Find all providers in zip 06355 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| 1255729349 | Bantam Fire Company | Ambulance | 92 Doyle Rd, Bantam, CT 06750-0456 | 2014-12-26 |
| 1972915924 | The Warren Volunteer Fire Company Incorporated | Ambulance | 11 Sackett Hill Rd, Warren, CT 06754-1713 | 2014-05-27 |
| 1033498027 | Wilton Volunteer Ambulance Corps Inc | Ambulance | 234 Danbury Rd, Wilton, CT 06897-4008 | 2011-08-09 |
| 1245553973 | Scotland Volunteer Fire Department Inc | Ambulance | 47 Brook Rd, Scotland, CT 06264 | 2010-03-09 |
| 1720220429 | Bethel Police Department | Ambulance | 49 Plumtrees Rd, Bethel, CT 06801-1616 | 2009-03-27 |
| 1558508879 | New Milford Community Ambulance Corp | Ambulance | 1 Scoville Street, New Milford Community Ambulance Corp, New Milford, CT 06776-0102 | 2009-01-08 |
| 1487837241 | Skmp Enterprises, Inc. | Ambulance | 279 Noble Ave, Bridgeport, CT 06608-2210 | 2007-12-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.