Sullivan Paramedicine, Inc

Primary specialty

ParamedicTaxonomy code 146L00000X

License

09295 Issued in NY

Legal business name

SULLIVAN PARAMEDICINE, INC

Doing business as

Mobilemedic EMS

Practice address

266 Main St
Hurleyville, NY 12747-5431

Phone

(845) 436-9111

Fax

(845) 436-8313

NPI assigned

May 27, 2005

Last updated

Aug 17, 2018By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Gina Bockman

Title

Vice President

Phone

(845) 436-9111

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mobilemedic EMS Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1053314559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1",
            "city": "HURLEYVILLE",
            "state": "NY",
            "postal_code": "127470001",
            "telephone_number": "845-436-9111",
            "fax_number": "845-436-8313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 MAIN ST",
            "city": "HURLEYVILLE",
            "state": "NY",
            "postal_code": "127475431",
            "telephone_number": "845-436-9111",
            "fax_number": "845-436-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN PARAMEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-27",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "BOCKMAN",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "845-436-9111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "146L00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Paramedic",
            "state": "NY",
            "license": "09295",
            "primary": true
        },
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "NY",
            "license": "09295",
            "primary": false
        },
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "NY",
            "license": "09295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02415772",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mobilemedic EMS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Paramedic in Hurleyville, NY
• Providers in Hurleyville, NY by specialty
• Paramedic in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.