Greenville Township Volunteer Ambulance Corps Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

32645 Issued in NY

Legal business name

GREENVILLE TOWNSHIP VOLUNTEER AMBULANCE CORPS INC

Practice address

1495 Greenville Turnpike
Port Jervis, NY 12771

Phone

(845) 858-0954

NPI assigned

Jun 3, 2016

Organization subpart

No

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

Authorized official

Name

Maureen Entwistle

Title

President

Phone

(845) 858-0954

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469577600000",
    "number": "1922456649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 SHERIDAN DR",
            "address_2": "SUITE 3B",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213730",
            "telephone_number": "716-504-3350",
            "fax_number": "716-634-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 GREENVILLE TURNPIKE",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "12771",
            "telephone_number": "845-858-0954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE TOWNSHIP VOLUNTEER AMBULANCE CORPS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-07-27",
        "status": "A",
        "authorized_official_last_name": "ENTWISTLE",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "845-858-0954"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "32645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deanna L Gorton, RN
• Christine E Goudreau, PTA
• Donna Ann Goulette, LICENSED
• Herbert M Green, MD
• Kimberly Greenfield
• Timothy Richard Gregory, LCSW
• Frances M Griffin, LCSW
• Eric Thomas Haley
• Toni Hall, CASAC
• Peter Hamilton, MD

• Land Ambulance in Port Jervis, NY
• Providers in Port Jervis, 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 Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.