1770562910 NPI number — PARKLAND AMBULANCE SERVICE, INC.

Table of content: (NPI 1770562910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1770562910 NPI number — PARKLAND AMBULANCE SERVICE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARKLAND AMBULANCE SERVICE, 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:
MOHAWK AMBULANCE SERVICE
Provider Other Organization Name Type Code:
3
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:
1770562910
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
357 KINGS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHENECTADY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12304-3645
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-374-4468
Provider Business Mailing Address Fax Number:
518-374-4685

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
357 KINGS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12304-3645
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-374-4468
Provider Business Practice Location Address Fax Number:
518-374-4685
Provider Enumeration Date:
01/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCPARTLON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
P
Authorized Official Title or Position:
VICE-PRESIDENT
Authorized Official Telephone Number:
518-346-5060

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  10027 , 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: 422130000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1001879 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5140 . This is a "WELLCARE OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00320407 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: A02151 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000479001009 . This is a "BS NENY 911 CALLS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10017574 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000400346001 . This is a "BS OF NENY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1712373 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 017858700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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