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Albany County

Organization Active NPI Land Ambulance · Clarksville, NY

NPI 1356570592 · NPPES record last updated Jan 22, 2018

Key facts

NPI
1356570592
Entity type
Organization (NPI type 2)
Primary specialty
Land Ambulance 3416L0300X
License
6229 (NY)
Legal business name
ALBANY COUNTY
Practice address
58 Verda Ave
Clarksville, NY 12041
Phone
(518) 655-7846
Fax
(518) 655-7707
NPI assigned
Jul 9, 2009
Organization subpart
No

Authorized official

Name
Brian Wood
Title
Captain
Phone
(518) 655-7846

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Albany County Skilled Nursing Facility · Albany, NY · NPI 1952309536
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · OPERATIONAL/MANAGERIAL CONTROL
  • Albany County Nursing Home Skilled Nursing Facility · Albany, NY · NPI 1801815915
    CMS ownership 5% OR GREATER DIRECT OWNERSHIP INTEREST · OPERATIONAL/MANAGERIAL CONTROL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Shaker Place Rehabiliation and Nursing Center
Albany, NY · CCN 335425		 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Jul 1, 1970
Jul 1, 1970

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100803000271 NY Part B Supplier - Ambulance Service Supplier 8224941331 Practice locations: Clarksville, NY

National Provider Directory

Locations

175 Green St
Albany, NY 12202
Phone (518) 447-4537

260 S Pearl St
Albany, NY 12202
Phone (518) 447-4550

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Land Ambulance 3416L0300X 6229 NY Yes

Addresses

Primary practice location

58 Verda Ave
Clarksville, NY 12041

Mailing address

PO Box 315
Voorheesville, NY 12186
Phone (518) 655-7846

Other names

  • Sheriff's Office EMS Unit Other name

Other providers in Clarksville, NY

All providers in Clarksville, NY · Land Ambulance in New York

Sources for this page

Verify at the official NPI Registry.