Active NPI
Grafton Rescue Squad
- Ambulance
- Grafton, NY
National Provider Identifier
1790163749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulance
- License
- K23483
- Legal business name
- GRAFTON RESCUE SQUAD
- Practice address
- 2379 Ny RT 2
Grafton, NY 12082 - Phone
- (518) 279-1388
- Fax
- (518) 279-3685
- NPI assigned
- May 11, 2015
- Last updated
- Apr 18, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Sonja B Haber
- Title
- Treasurer
- Phone
- (888) 603-2455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulance | 341600000X | K23483 | NY | Primary |
Addresses
Primary practice location
2379 Ny RT 2
Grafton, NY 12082
Mailing address
PO Box 117
Grafton, NY 12082
Phone (518) 279-1388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20161128001249 | NY | Part B Supplier - Ambulance Service Supplier | 1658650106 | Practice locations: Grafton, NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431302400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1681776000000",
"number": "1790163749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 117",
"city": "GRAFTON",
"state": "NY",
"postal_code": "12082",
"telephone_number": "518-279-1388",
"fax_number": "518-279-3685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2379 NY RT 2",
"city": "GRAFTON",
"state": "NY",
"postal_code": "12082",
"telephone_number": "518-279-1388",
"fax_number": "518-279-3685"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRAFTON RESCUE SQUAD",
"organizational_subpart": "NO",
"enumeration_date": "2015-05-11",
"last_updated": "2023-04-18",
"certification_date": "2023-04-18",
"status": "A",
"authorized_official_last_name": "HABER",
"authorized_official_first_name": "SONJA",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "TREASURER",
"authorized_official_telephone_number": "888-603-2455",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "341600000X",
"taxonomy_group": "",
"desc": "Ambulance",
"state": "NY",
"license": "K23483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; 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.