Colrain Vol Amb Assoc, Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

3369 Issued in MA

Legal business name

COLRAIN VOL AMB ASSOC, INC

Practice address

51 Main Rd
Colrain, MA 01340-5501

Phone

(413) 624-5528

NPI assigned

Oct 5, 2005

Last updated

Feb 28, 2013By 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

Gary Ponce

Title

Ceo/Director

Phone

(413) 624-0128

Specialties & licenses 1

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362009600000",
    "number": "1205823085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 TURCOTTE MEMORIAL DR",
            "city": "ROWLEY",
            "state": "MA",
            "postal_code": "019691706",
            "telephone_number": "800-488-4351",
            "fax_number": "978-356-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 MAIN RD",
            "city": "COLRAIN",
            "state": "MA",
            "postal_code": "013405501",
            "telephone_number": "413-624-5528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLRAIN VOL AMB ASSOC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2013-02-28",
        "status": "A",
        "authorized_official_last_name": "PONCE",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "CEO/DIRECTOR",
        "authorized_official_telephone_number": "413-624-0128"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "MA",
            "license": "3369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "042349458",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1715585",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "076259",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "590012303",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "807136",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "MH1050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET PLAN",
            "identifier": "000000027770",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ambulance in Colrain, MA
• Providers in Colrain, MA by specialty
• Ambulance in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2013; 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.

Verify at the official NPI Registry.