INDIAN LAKE VOLUNTEER AMBULANCE CORP INC (NPI# 1922394543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922394543 |
| Entity Type | Organization |
| Organization Name | INDIAN LAKE VOLUNTEER AMBULANCE CORP INC |
| Practice Address |
105 Pelon Road Indian Lake NY 12842-0117 |
| Mailing Address |
6231 Nys Rt 30 Indian Lake NY 12842-0039 |
| Practice Telephone | 5186480095 |
| Practice Fax Number | 5186480095 |
| Mailing Telephone | 5186480095 |
| Mailing Fax Number | 5186480095 |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2018-10-28 |
| Authorized Official Name | MRS. JOSHUA B WELLS (OPERATIONS MANAGER) |
| Authorized Official Telephone | 5187960507 |
| Authorized Official Credential | EMT-CC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3416L0300X |
Ambulance Specialization: Land Transport |
12170 | NY | Transportation Services |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03433790 | 05 |
| Street Address |
105 PELON ROAD |
| City | INDIAN LAKE |
| State | NY |
| Zip Code | 12842-0117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417226978 | Renee Ann Blowers | Registered Nurse | 81 White Birch Lane, Indian Lake, NY 12842 | 2011-12-29 |
| 1447408455 | Tracey Hunt | Registered Nurse | 250 White Birch Lane, Indian Lake, NY 12842 | 2008-09-03 |
| 1912295049 | Sherry L Warner | Registered Nurse | 250 White Birch Lane, Indian Lake, NY 12842 | 2011-07-11 |
| 1477701167 | Maria Lourdes Belyea | Registered Nurse | White Birch Lane, Indian Lake, NY 12842 | 2008-09-05 |
| 1649428558 | Jonathan Callahan Stanton | Registered Nurse | 250 White Birch Lane, Indian Lake, NY 12842 | 2008-09-04 |
| 1023436334 | Daryl Parslow | Case Manager/Care Coordinator | 139 White Birch Lane, Indian Lake, NY 12842-0139 | 2014-04-03 |
| 1033420963 | Karen Ann Levison | Physical Therapy Assistant | 477 Adirondack Lake Road, Indian Lake, NY 12842-0204 | 2010-06-25 |
| 1013165604 | Beth Waldron | Registered Nurse | 0 White Birch Lane, Indian Lake, NY 12842-0250 | 2008-09-08 |
| 1649428749 | Avis Kim Warner | Registered Nurse | White Birch Lane, Indian Lake, NY 12842-0250 | 2008-09-03 |
| 1801977376 | Hamilton County | Home Health | 139 White Birch Lane, Indian Lake, NY 12842-0250 | 2006-10-18 |
| Find all providers in zip 12842 | ||||
| Taxonomy Code | 3416L0300X |
| Grouping | Transportation Services |
| Classification | Ambulance |
| Specialization | Land Transport |
| Definition to come... |
| Notes: [1/1/2005: title modified] |
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| Find all providers with the same taxonomy | ||||
| City | INDIAN LAKE |
| Zip Code | 12842 |
Please comment or provide details below to improve the information on INDIAN LAKE VOLUNTEER AMBULANCE CORP 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.