Raquette Lake Volunteer Ambulance Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1086 Issued in NY

Legal business name

RAQUETTE LAKE VOLUNTEER AMBULANCE SQUAD INC

Practice address

171 Route 28
Raquette Lake, NY 13436-0125

Phone

(315) 354-4644

Fax

(315) 354-4228

NPI assigned

Mar 24, 2014

Last updated

Mar 24, 2014By 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

Mr. Corky Risley

Title

Business Manager

Phone

(315) 723-9041

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395619200000",
    "number": "1427475854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 125",
            "city": "RAQUETTE LAKE",
            "state": "NY",
            "postal_code": "134360125",
            "telephone_number": "315-354-4644",
            "fax_number": "315-354-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ROUTE 28",
            "city": "RAQUETTE LAKE",
            "state": "NY",
            "postal_code": "134360125",
            "telephone_number": "315-354-4644",
            "fax_number": "315-354-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAQUETTE LAKE VOLUNTEER AMBULANCE SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-24",
        "last_updated": "2014-03-24",
        "status": "A",
        "authorized_official_last_name": "RISLEY",
        "authorized_official_first_name": "CORKY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "315-723-9041",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "1086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Hugh Bennett, MD
• Raquette Lake Fire Department Inc

• Land Ambulance in Raquette Lake, NY
• Providers in Raquette Lake, NY by specialty
• Land Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; 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.