Healthcare Provider Details

I. General information

NPI: 1720822257
Provider Name (Legal Business Name): CONSTABLE VOLUNTEER FIREMEN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2024
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1136 STATE ROUTE 122
CONSTABLE NY
12926-7700
US

IV. Provider business mailing address

8610 MAIN ST
WILLIAMSVILLE NY
14221-7455
US

V. Phone/Fax

Practice location:
  • Phone: 518-483-5908
  • Fax:
Mailing address:
  • Phone: 716-204-3350
  • Fax: 716-247-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. LUKAS KOMPAN
Title or Position: CAPTAIN
Credential: RN, NREMT
Phone: 518-481-7247