Healthcare Provider Details

I. General information

NPI: 1316639966
Provider Name (Legal Business Name): LAKE CARMEL EMERGENCY MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2023
Last Update Date: 05/23/2023
Certification Date: 05/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

851 ROUTE 52
CARMEL NY
10512-4728
US

IV. Provider business mailing address

PO BOX 4110
WOBURN MA
01888-4110
US

V. Phone/Fax

Practice location:
  • Phone: 845-225-7000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MARY RODDA
Title or Position: PRESIDENT
Credential:
Phone: 845-225-7000