Healthcare Provider Details

I. General information

NPI: 1073557849
Provider Name (Legal Business Name): CASTLETON VOLUNTEER AMBULANCE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 BROOKVIEW ROAD
CASTLETON NY
12033-9702
US

IV. Provider business mailing address

PO BOX 787
LATHAM NY
12110-0787
US

V. Phone/Fax

Practice location:
  • Phone: 518-732-2563
  • Fax:
Mailing address:
  • Phone: 888-603-2455
  • Fax: 888-603-2455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: BETH KNAUF SECOR
Title or Position: BILLING SPECIALIST
Credential:
Phone: 888-603-2455