Middleburgh Emergency Volunteer Ambulance Corps Inc
Organization Active NPI Ambulance · Middleburgh, NY
NPI 1780023705 · NPPES record last updated Jun 26, 2014
Key facts
- NPI
- 1780023705
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulance 341600000X
- License
- 4717 (NY)
- Legal business name
- MIDDLEBURGH EMERGENCY VOLUNTEER AMBULANCE CORPS INC
- Practice address
- 142 Cotton Hill Road
Middleburgh, NY 12122-9998 - Phone
- (518) 827-8098
- NPI assigned
- Jun 24, 2013
- Organization subpart
- No
Authorized official
- Name
- Mrs. Mary T Gentile
- Title
- Authorized Agent
- Phone
- (860) 257-7080
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20140124000072 | NY | Part B Supplier - Ambulance Service Supplier | 1052549870 | Practice locations: Middleburgh, NY |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | 4717 | NY | Yes |
Addresses
Primary practice location
142 Cotton Hill Road
Middleburgh, NY 12122-9998
Mailing address
PO Box 290184
Wethersfield, CT 06129-0184
Phone (860) 257-7080
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03828911 | Medicaid | NY |
Other providers in Middleburgh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.