Gowanda Ambulance Service Corp

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

GOWANDA AMBULANCE SERVICE CORP

Practice address

225 Aldrich Street
Gowanda, NY 14070

Phone

(716) 532-4884

NPI assigned

Jan 14, 2009

Last updated

Aug 17, 2024By 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

Diane Marie Moppert

Title

President

Phone

(716) 532-2025

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723852800000",
    "number": "1588801468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8610 MAIN STREET",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217455",
            "telephone_number": "716-204-3350",
            "fax_number": "716-247-5274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 ALDRICH STREET",
            "city": "GOWANDA",
            "state": "NY",
            "postal_code": "14070",
            "telephone_number": "716-532-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOWANDA AMBULANCE SERVICE CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2024-08-17",
        "certification_date": "2024-08-17",
        "status": "A",
        "authorized_official_last_name": "MOPPERT",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-532-2025"
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "11014",
            "primary": false
        },
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Edminster, LPN
• G N H LLC
• GNH LLC (Gowanda Rehabilitation & Nursing Center)
• Jennifer Gollus, M.S., OTR/L
• Gornc Operating LLC (Gowanda Rehabilitation & Nursing Center)
• Gowanda Central School
• Gowanda Correctional Facility
• Gowanda Eye Care, Inc.
• Grover Optical LLC (Gowanda Eyecare)
• Allan Grover

• Land Ambulance in Gowanda, NY
• Providers in Gowanda, 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 Aug 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.