Healthcare Provider Details

I. General information

NPI: 1124150958
Provider Name (Legal Business Name): TOWN OF HIGHLANDS AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 07/29/2022
Certification Date: 07/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 MAIN ST
HIGHLAND FALLS NY
10928-1804
US

IV. Provider business mailing address

8610 MAIN STREET
WILLIAMSVILLE NY
14221
US

V. Phone/Fax

Practice location:
  • Phone: 845-446-4280
  • Fax: 845-446-6507
Mailing address:
  • Phone: 716-204-3350
  • Fax: 716-247-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number3527
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: MERVIN R LIVSEY
Title or Position: TOWN SUPERVISOR
Credential:
Phone: 845-446-4280