Irvington Volunteer Ambulance Corps Inc
Organization Active NPI Ambulance · Irvington, NY
NPI 1114901790 · NPPES record last updated Nov 26, 2024
Key facts
- NPI
- 1114901790
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 10375 (NY)
- Legal business name
- IRVINGTON VOLUNTEER AMBULANCE CORPS INC
- Practice address
- 80 Main St
Irvington, NY 10533-1719 - Phone
- (914) 591-5151
- NPI assigned
- Dec 6, 2005
- Organization subpart
- No
Authorized official
- Name
- Lucas Isola
- Title
- Captain
- Phone
- (914) 591-5151
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2271942 | Irvington Volunteer Ambulance Corps | 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 |
|---|---|---|---|---|
| O20111128000063 | NY | Part B Supplier - Ambulance Service Supplier | 5193999332 | Practice locations: Irvington, NY |
National Provider Directory
Locations
80 Main St
Irvington, NY 10533
Phone (914) 591-5151
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 10375 | NY | Yes |
| Land Ambulance | 3416L0300X |
Addresses
Primary practice location
80 Main St
Irvington, NY 10533-1719
Mailing address
PO Box 535
Baldwinsville, NY 13027-0535
Phone (315) 635-1789
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01581786 | Medicaid | NY | |
| 602651 | Other | MVP | |
| 590009536 | Other | PALMETTO GBA RAILROAD | |
| 9610523 | Other | GHI |
Other providers in Irvington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 26, 2024. 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.