Healthcare Provider Details

I. General information

NPI: 1912079286
Provider Name (Legal Business Name): LAFAYETTE AMBULANCE DEPARTMENT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2444 RTE 11 SOUTH
LAFAYETTE NY
13084
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 315-677-3400
  • Fax: 315-677-3417
Mailing address:
  • Phone: 800-927-5845
  • Fax: 315-635-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0401
License Number StateNY

VIII. Authorized Official

Name: ASHLIE CARRIER
Title or Position: TREASURER
Credential:
Phone: 315-677-3400