Healthcare Provider Details

I. General information

NPI: 1407837834
Provider Name (Legal Business Name): BROOME VOLUNTEER EMERGENCY SQUAD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2005
Last Update Date: 11/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 COURT ST
BINGHAMTON NY
13901-3602
US

IV. Provider business mailing address

PO BOX 29895
NEW YORK NY
10087-9895
US

V. Phone/Fax

Practice location:
  • Phone: 855-978-6303
  • Fax: 888-965-4620
Mailing address:
  • Phone: 855-978-6303
  • Fax: 888-965-4620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number91091
License Number StateNY

VIII. Authorized Official

Name: STEVEN BROWN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 607-772-6565