Tupper Lake Volunteer Ambulance & Emergency Squad Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

1619 Issued in NY

Legal business name

TUPPER LAKE VOLUNTEER AMBULANCE & EMERGENCY SQUAD INC

Practice address

49 High St
Tupper Lake, NY 12986-1713

Phone

(585) 768-2192

NPI assigned

Feb 28, 2006

Last updated

Mar 11, 2008By 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

Bob Collier

Title

Administrator

Phone

(585) 768-2192

Specialties & licenses 1

Addresses

Other identifiers 1

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": "1141084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1730155664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144820186",
            "telephone_number": "585-768-2192",
            "fax_number": "585-768-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 HIGH ST",
            "city": "TUPPER LAKE",
            "state": "NY",
            "postal_code": "129861713",
            "telephone_number": "585-768-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUPPER LAKE VOLUNTEER AMBULANCE & EMERGENCY SQUAD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-28",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "BOB",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "585-768-2192"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "1619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01496859",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• State of New York
• State of New York
• Lisa Rae Tebo, OTR/L
• Tupper Lake Center LLC (Tupper Lake Center for Nursing and Rehabilitation)
• Tupper Lake Central School District
• Walgreen Co (Walgreens #19706)
• Matthew S Warner, RPH
• Melanie Werenczak
• Shelley Jean Whiteman I, CASAC-ADVANCED
• Steven D Wilson, DDS

• Land Ambulance in Tupper Lake, NY
• Providers in Tupper 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 11, 2008; 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.