MEDICARE: GREATER BALDWINSVILLE AMBULANCE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	10475	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	951017	OTHER	MVP
3	59007883	OTHER	PALMETTO GBA RAILROAD
4	3200259	OTHER	GHI

General Provider Information

NPI Number	:	1346227683
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREATER BALDWINSVILLE AMBULANCE CORP

Provider Business Mailing Address
First Line	:	PO BOX 535
Second Line	:
City	:	BALDWINSVILLE
State	:	NY
Zip	:	13027-0535
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 ALBERT PALMER LN
Second Line	:
City	:	BALDWINSVILLE
State	:	NY
Zip	:	13027-2401
Country	:	US
Telephone Number	:	315-638-4328
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK PROCOPIO
Credential	:
Telephone Number	:	315-391-8325

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	12/15/2025

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