Active NPI
Stanley Hall Gorham Ambulance Service, Inc.
- Land Ambulance
- Hall, NY
National Provider Identifier
1003882929
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Land Ambulance
- License
- 3420
- Legal business name
- STANLEY HALL GORHAM AMBULANCE SERVICE, INC.
- Practice address
- 4890 State Route 14a
Hall, NY 14463-9008 - Phone
- (585) 526-5944
- Fax
- (585) 526-5744
- NPI assigned
- Feb 28, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael Moss
- Title
- President
- Phone
- (585) 509-1636
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | 3420 | NY | Primary |
Addresses
Primary practice location
4890 State Route 14a
Hall, NY 14463-9008
Mailing address
PO Box 57
Hall, NY 14463-0057
Phone (585) 526-5944
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01654360 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080627000088 | NY | Part B Supplier - Ambulance Service Supplier | 2264504844 | Practice locations: Stanley, NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141084800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1767052800000",
"number": "1003882929",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 57",
"city": "HALL",
"state": "NY",
"postal_code": "144630057",
"telephone_number": "585-526-5944",
"fax_number": "585-526-5744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4890 STATE ROUTE 14A",
"city": "HALL",
"state": "NY",
"postal_code": "144639008",
"telephone_number": "585-526-5944",
"fax_number": "585-526-5744"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STANLEY HALL GORHAM AMBULANCE SERVICE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-28",
"last_updated": "2025-12-30",
"certification_date": "2025-12-30",
"status": "A",
"authorized_official_last_name": "MOSS",
"authorized_official_first_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "585-509-1636"
},
"taxonomies": [
{
"code": "3416L0300X",
"taxonomy_group": "",
"desc": "Ambulance, Land Transport",
"state": "NY",
"license": "3420",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01654360",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hall, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.