1144558594 NPI number — CITY OF GLENS FALLS

Table of content: (NPI 1144558594)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144558594 NPI number — CITY OF GLENS FALLS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF GLENS FALLS
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:
GLENS FALLS FIRE DEPARTMENT AMBULANCE
Provider Other Organization Name Type Code:
5
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:
1144558594
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 787
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LATHAM
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12110-0787
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-603-2455
Provider Business Mailing Address Fax Number:
888-603-2455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
134 RIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLENS FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12801-3220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-603-2455
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/23/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BERRY
Authorized Official First Name:
PETER
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
BILLING MANAGER
Authorized Official Telephone Number:
518-495-5930

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  6231 , 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)