Ontario County Advanced Life Support, Inc

Primary specialty

AmbulanceTaxonomy code 341600000X

License

3496 Issued in NY

Legal business name

ONTARIO COUNTY ADVANCED LIFE SUPPORT, INC

Practice address

233 N Pearl St
Canandaigua, NY 14424-1439

Phone

(585) 396-6672

Fax

(585) 396-0154

NPI assigned

Jan 17, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Reginald Allen

Title

Chief

Phone

(585) 396-6672

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760534036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 PARRISH ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241731",
            "telephone_number": "585-396-6672",
            "fax_number": "585-396-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 N PEARL ST",
            "city": "CANANDAIGUA",
            "state": "NY",
            "postal_code": "144241439",
            "telephone_number": "585-396-6672",
            "fax_number": "585-396-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONTARIO COUNTY ADVANCED LIFE SUPPORT, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "585-396-6672",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "341600000X",
            "taxonomy_group": "",
            "desc": "Ambulance",
            "state": "NY",
            "license": "3496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01895192",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "P0100637AL",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE #",
            "identifier": "104405FY",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacalyn Dawn Oloughlin, REGISTERED NURSE
• Kayode A Olowomeye
• Joshua Olsen, M.D.
• Ontario County
• Ontario County
• Ontario County County Treas
• Ontario County Early Intervention
• Ontario County Early Intervention
• Ontario County Health Facility
• Ontario County LT Home Health Agency

• Ambulance in Canandaigua, NY
• Providers in Canandaigua, NY by specialty
• Ambulance in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.