1497736821 NPI number — VESTAL VOLUNTEER EMERGENCY SQUAD INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497736821 NPI number — VESTAL VOLUNTEER EMERGENCY SQUAD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VESTAL VOLUNTEER EMERGENCY SQUAD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497736821
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 126 WVS
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BINGHAMTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-969-9722
Provider Business Mailing Address Fax Number:
800-693-3172

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
324 MYRTLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VESTAL
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-748-6618
Provider Business Practice Location Address Fax Number:
607-786-7610
Provider Enumeration Date:
11/11/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SCOTT
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
607-723-4554

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  10161 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01702381 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com