BLACK RIVER AMBULANCE SQUAD, INC (NPI# 1972793602) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1972793602 |
Entity Type | Organization |
Organization Name | BLACK RIVER AMBULANCE SQUAD, INC |
Practice Address |
121 Leray St Black River NY 13612-2114 |
Mailing Address |
121 Leray St Po Box 314 Black River NY 13612-2114 |
Practice Telephone | 3157734501 |
Practice Fax Number | 3157750291 |
Mailing Telephone | 3157734501 |
Mailing Fax Number | 3157750291 |
Enumeration Date | 2007-07-30 |
Last Update Date | 2007-07-30 |
Authorized Official Name | MR. ALAN CLAUDE GAINES (BILLING OFFICER) |
Authorized Official Telephone | 3157734501 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 3416L0300X |
Ambulance Specialization: Land Transport |
2232 | NY | Transportation Services |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 01793580 | 05 |
Street Address |
121 LERAY ST |
City | BLACK RIVER |
State | NY |
Zip Code | 13612-2114 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861041592 | Mary Cecilia Therese Runge | Speech-Language Pathologist | 28819 Nys Rt. 342, Black River, NY 13612 | 2019-09-05 |
1215258967 | Wendy L Eddy | Counselor | 21534 Staplin Road, Black Rivewr, NY 13612 | 2010-06-17 |
1861619066 | Daniel George Greene | Counselor | 21544 Miser Road, Black River, NY 13612 | 2007-04-19 |
1235338799 | Robert Paul Edgar | Licensed Practical Nurse | 30204 State Route 3, Black River, NY 13612-2091 | 2007-07-15 |
1790968469 | Tammy Kelsey Perez | Occupational Therapist | 30081 Nys Rte 3, Black River, NY 13612-2093 | 2007-12-17 |
1114178001 | Nids Coalition Northern Chapter | General Practice | 103 S Main St, Black River, NY 13612-2101 | 2008-10-09 |
1801445986 | Jessica Dawn Whitmore | Social Worker | 121 N Main St, Black River, NY 13612-2109 | 2019-09-10 |
1144219197 | Hans Werner Wawrousek Jr. | Dentist | 122 Pine Dr, Black River, NY 13612-2110 | 2005-10-20 |
1710289244 | Elizabeth Leigh Elmer | Speech-Language Pathologist | 160 Leray St, Black River, NY 13612-2114 | 2010-12-05 |
1295906410 | Samantha Ann Schirmer | Licensed Practical Nurse | 27882 State Route 342 Lot 217, Black River, NY 13612-2123 | 2008-03-14 |
Find all providers in zip 13612 |
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 | BLACK RIVER |
Zip Code | 13612 |
Please comment or provide details below to improve the information on BLACK RIVER AMBULANCE SQUAD, 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.