Southeast Quadrant Mobile Critical Care Unit Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

SOUTHEAST QUADRANT MOBILE CRITICAL CARE UNIT INC

Practice address

25247 Baird Road
Penfiled, NY 14526-2332

Phone

(585) 218-0025

Fax

(585) 218-0025

NPI assigned

Feb 28, 2006

Last updated

Dec 16, 2016By 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

Ann Nichols

Title

President

Phone

(585) 218-0026

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481846400000",
    "number": "1093782922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 SHERIDAN DR",
            "address_2": "SUITE 3B",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213730",
            "telephone_number": "716-204-3350",
            "fax_number": "716-634-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25247 BAIRD ROAD",
            "city": "PENFILED",
            "state": "NY",
            "postal_code": "145262332",
            "telephone_number": "585-218-0025",
            "fax_number": "585-218-0025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEAST QUADRANT MOBILE CRITICAL CARE UNIT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2016-12-16",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-218-0026"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "2797",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MONROE PLAN",
            "identifier": "PSEQUADMOBIL",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "590015041",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2016; 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.