Healthcare Provider Details

I. General information

NPI: 1508902800
Provider Name (Legal Business Name): DURHAM AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 12/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MILKRUN ROAD
EAST DURHAM NY
12423
US

IV. Provider business mailing address

PO BOX 106
OAK HILL NY
12460
US

V. Phone/Fax

Practice location:
  • Phone: 518-239-6100
  • Fax: 518-239-6127
Mailing address:
  • Phone: 518-239-6100
  • Fax: 518-239-6127

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number1921
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateNY

VIII. Authorized Official

Name: MR. BRUCE REAY MAHLER
Title or Position: PRESIDENT
Credential:
Phone: 518-291-6335