Healthcare Provider Details

I. General information

NPI: 1124002936
Provider Name (Legal Business Name): JEFFERSONVILLE VOLUNTEER FIRST AID CORPS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2005
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 CALLICOON CENTER RD
JEFFERSONVILLE NY
12748
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 845-482-3110
  • Fax:
Mailing address:
  • Phone: 845-482-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number09442
License Number StateNY

VIII. Authorized Official

Name: RUTH ACKERMANN
Title or Position: CAPTAIN
Credential:
Phone: 845-482-3110