Tri-Community Ambulance Service Inc

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

License

3112 Issued in NY

Legal business name

TRI-COMMUNITY AMBULANCE SERVICE INC

Practice address

6276 Ward Rd
Sanborn, NY 14132-9232

Phone

(585) 768-2192

NPI assigned

Mar 1, 2006

Last updated

Feb 27, 2013By 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

Kenny Devole

Title

President

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": "1141171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1972570695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 E MAIN RD",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144829704",
            "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": "6276 WARD RD",
            "city": "SANBORN",
            "state": "NY",
            "postal_code": "141329232",
            "telephone_number": "585-768-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COMMUNITY AMBULANCE SERVICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-01",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "DEVOLE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "585-768-2192"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": "NY",
            "license": "3112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01400182",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Phillip John Sowicki, RN
• Malerie Marie Staskiewicz
• Sarah A Tabone, BA
• Pamela Tavenier, LPN
• Matt Paul Terranova
• Ryan Wagner, PHARMD
• Loren John Wehling, AGNP
• Regina Weise
• Ralph Wilson, CASAC
• Ericka Danielle Zahn

• Land Ambulance in Sanborn, NY
• Providers in Sanborn, 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 Feb 27, 2013; 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.