MEDICARE: COMMONWEALTH AMBULANCE SERVICE

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	3042	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Q00234	OTHER		BCBS OF MA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992727846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMONWEALTH AMBULANCE SERVICE

Provider Business Mailing Address
First Line	:	PO BOX 535
Second Line	:
City	:	BALDWINSVILLE
State	:	NY
Zip	:	13027
Country	:	US
Telephone Number	:	315-635-1789
Fax Number	:	315-635-3289

Provider Business Practice Location Address
First Line	:	150 WEST ST
Second Line	:
City	:	NEEDHAM HEIGHTS
State	:	MA
Zip	:	02494
Country	:	US
Telephone Number	:	781-449-6814
Fax Number	:	781-449-6874

Authorized Official
Title or Position	:	CCO OWNER
Name	:	THOMAS DUNLAY JR.
Credential	:
Telephone Number	:	781-449-6814

Provider Enumeration Date	:	07/23/2006
Last Update Date	:	08/22/2020

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Directions to “COMMONWEALTH AMBULANCE SERVICE ” Practice Location

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