Wells Volunteer Ambulance Corps
Organization Active NPI Land Ambulance · Wells, NY
NPI 1104524016 · NPPES record last updated Mar 28, 2023
Key facts
- NPI
- 1104524016
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Land Ambulance 3416L0300X
- Legal business name
- WELLS VOLUNTEER AMBULANCE CORPS
- Practice address
- 105 Buttermilk Hill Rd
Wells, NY 12190 - Phone
- (518) 924-4114
- NPI assigned
- Feb 20, 2023
- Organization subpart
- No
Authorized official
- Name
- Avis Warner
- Title
- Captain/Ceo
- Phone
- (518) 924-2108
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2326009 | Wells Volunteer Ambulance Corps Inc | Certificate of waiver | Mar 26, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230524000630 | NY | Part B Supplier - Ambulance Service Supplier | 4789040338 | Practice locations: Wells, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Land Ambulance | 3416L0300X | Yes |
Addresses
Primary practice location
105 Buttermilk Hill Rd
Wells, NY 12190
Mailing address
PO Box 501
Wells, NY 12190-0501
Phone (518) 573-2706
Other providers in Wells, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.