1902864606 NPI number — NEW WINDSOR VOLUNTEER AMBULANCE CORPS INC

Table of content: (NPI 1902864606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902864606 NPI number — NEW WINDSOR VOLUNTEER AMBULANCE CORPS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW WINDSOR VOLUNTEER AMBULANCE CORPS 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:
NEW WINDSOR EMERGENCY MEDICAL SERVICES
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:
1902864606
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 UNION AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW WINDSOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12553-6140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-629-6958
Provider Business Mailing Address Fax Number:
845-563-3119

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 UNION AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW WINDSOR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12553-6140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-629-6958
Provider Business Practice Location Address Fax Number:
845-563-3119
Provider Enumeration Date:
05/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BIGG
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
CHIEF OF OPERATIONS
Authorized Official Telephone Number:
845-563-3114

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X , with the licence number:  12645 , 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: 02779404 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00319464 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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