SOUTH WINDSOR AMBULATORY CARE CTR INC (NPI# 1760408835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760408835 |
| Entity Type | Organization |
| Organization Name | SOUTH WINDSOR AMBULATORY CARE CTR INC |
| Practice Address |
2800 Tamarack Avenue Suite 105 South Windsor CT 06074-5539 |
| Mailing Address |
Po Box 510 South Windsor CT 06074-0510 |
| Practice Telephone | 8606443491 |
| Practice Fax Number | 8606445744 |
| Mailing Telephone | 8606443491 |
| Mailing Fax Number | 8606445744 |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2008-05-19 |
| Authorized Official Name | MRS. BARBARA M PETRONE (OFFICE MANAGER) |
| Authorized Official Telephone | 8606443491 |
| Authorized Official Credential | RTR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 024303 | CT | Allopathic & Osteopathic Physicians |
| Y | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
24303 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004263612 | 05 | |
| TX | AETNA | 514837 | 01 |
| GA | UNITED HEALTH CARE | 1751515 | 01 |
| CT | OXFORD | P3592661 | 01 |
| MA | TUFTS | 427750 | 01 |
| PA | CIGNA | 7294618 | 01 |
| CT | BLUE SHIELD OF CT | 010024303CT01 | 01 |
| CT | HEALTHNET | 0V0438 | 01 |
| CT | CONNECTICARE | 704554 | 01 |
| CT | GREAT WEST | 80705 | 01 |
| Street Address |
2800 TAMARACK AVENUE SUITE 105 |
| City | SOUTH WINDSOR |
| State | CT |
| Zip Code | 06074-5539 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902078900 | Loraine P. Lagace | Audiologist | 2800 Tamarack Avenue, Suite 102, South Windsor, CT 06074 | 2008-03-31 |
| 1194997197 | Valerie M. Knorr | Audiologist | 2800 Tamarack Avenue, Suite 102, South Windsor, CT 06074 | 2008-03-31 |
| 1659543650 | M Jeanne Evenson | Audiologist | 2800 Tamarack Avenue, Suite 102, South Windsor, CT 06074 | 2008-03-31 |
| 1497864516 | Eastern Connecticut Medical Professionals Foundation, Inc | Specialist | 2800 Tamarack Avenue, Suite 104, South Windsor, CT 06074 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144919 | Russo Therapeutics, LLC | Occupational Therapist | 561 King Street, South Windsor, CT 06074 | 2020-05-04 |
| 1144706631 | Chana Judith Hoagland | Nurse Practitioner | 276 Quarry Brook Drive, South Windsor, CT 06074 | 2018-07-17 |
| 1093203291 | Climb Medical Group LLC | Counselor | 828 Sullivan Ave Ste A, South Windsor, CT 06074 | 2018-04-24 |
| 1528506516 | William P Guinan, Md and Associates LLC | Obstetrics & Gynecology | 25 Oakland Road, South Windsor, CT 06074 | 2017-02-09 |
| 1487027678 | Nadine Caron | Nurse Practitioner | 34 Pleasant Valley Rd, South Windsor, CT 06074 | 2015-11-10 |
| 1275957920 | Ellen Carol Ronsivalli | Dietitian, Registered | 70 High Street, South Windsor, CT 06074 | 2014-02-14 |
| 1881036457 | Chandra Yellinedi | Pharmacist | 55 Frazer Fir, South Windsor, CT 06074 | 2013-07-24 |
| 1144665969 | Brian Thomas Moy | Internal Medicine | 2400 Tamarack Ave Ste 101, South Windsor, CT 06074 | 2013-05-07 |
| 1093072886 | Lydia Lormand | Obstetrics & Gynecology | 2600 Tamarack Ave Ste 200, South Windsor, CT 06074 | 2012-04-18 |
| 1578847307 | International Institute for Professional Development, LLC | Social Worker | 435 Buckland Hills Road, South Windsor, CT 06074 | 2011-09-28 |
| Find all providers in zip 06074 | ||||
| Taxonomy Code | 261QU0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Urgent Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548804628 | Urgent Care of West Hartford, LLC | Clinic/Center | 21 N Main St Ste B, West Hartford, CT 06107-1939 | 2019-11-01 |
| 1467937268 | Ctuc01 | Clinic/Center | 1171 E Main St, Torrington, CT 06790-3963 | 2018-09-27 |
| 1972035657 | New England Urgent Care Enfield LLC | Clinic/Center | 370 Middle Tpke W, Manchester, CT 06040-3824 | 2017-03-31 |
| 1396276960 | Ctuc01 | Clinic/Center | 76 Newtown Rd., Suite C, Danbury, CT 06810 | 2017-03-24 |
| 1922539592 | Ctuc01 | Clinic/Center | 179 Talcottville Rd, Vernon, CT 06066 | 2017-03-24 |
| 1134665698 | Bloomfield Urgent Care, LLC | Clinic/Center | 16 Mountain Ave, Bloomfield, CT 06002-2339 | 2017-01-09 |
| 1053856039 | Qmg3, LLC | Clinic/Center | 389 Bridgeport Ave, Shelton, CT 06824-5484 | 2016-12-29 |
| 1437546363 | Qmg2,llc | Clinic/Center | 1910 Black Rock Tpke, Fairfield, CT 06825-3543 | 2015-04-17 |
| 1629461116 | Urgent Care of Derby, LLC | Clinic/Center | 78 Pershing Dr, Derby, CT 06418-1433 | 2015-03-09 |
| 1558753574 | Ctuc01 | Clinic/Center | 100 Mill Plain Road, Danbury, CT 06811 | 2015-02-27 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH WINDSOR |
| Zip Code | 06074 |
Please comment or provide details below to improve the information on SOUTH WINDSOR AMBULATORY CARE CTR INC.
| 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.