ROY B PETTENGILL AMB ASSOC


Address: 10 Hebron Ave, Marlborough, CT 06447-1201
Phone: 8602956219

ROY B PETTENGILL AMB ASSOC (NPI# 1750379293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1750379293
Entity Type Organization
Organization Name ROY B PETTENGILL AMB ASSOC
Practice Address 10 Hebron Ave
Marlborough
CT 06447-1201
Mailing Address Po Box 290184
Wethersfield
CT 06129-0184
Practice Telephone 8602956219
Practice Fax Number 8602950604
Mailing Telephone 8004528191
Mailing Fax Number 8607216362
Enumeration Date 2005-10-10
Last Update Date 2020-08-22
Authorized Official Name MS. HEATHER M LIZOTTE (AUTHORIZED AGENT)
Authorized Official Telephone 8004528191
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 3416L0300X Ambulance
Specialization: Land Transport
C079B1 CT Transportation Services

Office Location

Street Address 10 HEBRON AVE
City MARLBOROUGH
State CT
Zip Code 06447-1201

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Taxonomy Information

Taxonomy Code 3416L0300X
Grouping Transportation Services
Classification Ambulance
Specialization Land Transport

Taxonomy Definition

Definition to come...
Notes: [1/1/2005: title modified]

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Competitor

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City MARLBOROUGH
Zip Code 06447

Improve Information

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Dataset Information

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.

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