Provider Demographics
NPI:1285317040
Name:SOUTH NEW BERLIN FIRE DEPARTMENT & RESCUE SQUAD
Entity type:Organization
Organization Name:SOUTH NEW BERLIN FIRE DEPARTMENT & RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:DOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-257-7080
Mailing Address - Street 1:PO BOX 290184
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06129-0184
Mailing Address - Country:US
Mailing Address - Phone:860-257-7080
Mailing Address - Fax:
Practice Address - Street 1:3519 STATE HIGHWAY 8
Practice Address - Street 2:
Practice Address - City:S NEW BERLIN
Practice Address - State:NY
Practice Address - Zip Code:13843-2311
Practice Address - Country:US
Practice Address - Phone:860-257-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance