WF Bruen Emergency Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

10455 Issued in NY

Legal business name

WF BRUEN EMERGENCY SQUAD INC

Practice address

1116 Red Mill Rd
Rensselaer, NY 12144-5503

Phone

(518) 477-8243

NPI assigned

Dec 20, 2005

Last updated

Jun 11, 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

Beverly Buff Conklin

Title

Billing MGR

Phone

(518) 424-0248

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

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

{
    "created_epoch": "1135036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370908800000",
    "number": "1639155823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 RED MILL RD",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121445503",
            "telephone_number": "518-477-8243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 RED MILL RD",
            "city": "RENSSELAER",
            "state": "NY",
            "postal_code": "121445503",
            "telephone_number": "518-477-8243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WF BRUEN EMERGENCY SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-20",
        "last_updated": "2013-06-11",
        "status": "A",
        "authorized_official_last_name": "BUFF CONKLIN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "518-424-0248"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "10455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02338810",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000900405000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP",
            "identifier": "281000003",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Ward
• Anne Marie Warrington, RN
• Deborah Wasserbach
• Adrienne Weitzel
• Charissa Lynn Wellington, LPN
• Aldene Whaley
• Sharon Lee Wheeler, MT-BC, LCAT, HTTP
• Stephanie Wilson
• Wolf Ridge Medical Wellness
• Kristin N Yannetti, M.D.

• Land Ambulance in Rensselaer, NY
• Providers in Rensselaer, 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 Jun 11, 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.