Healthcare Provider Details

I. General information

NPI: 1730179128
Provider Name (Legal Business Name): LANCASTER VOLUNTEER AMBULANCE CORPS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 11/07/2024
Certification Date: 11/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 EMBRY PLACE
LANCASTER NY
14086-1703
US

IV. Provider business mailing address

8610 MAIN STREET
WILLIAMSVILLE NY
14221-7455
US

V. Phone/Fax

Practice location:
  • Phone: 716-683-3282
  • Fax: 716-683-5466
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 Number1484
License Number StateNY

VIII. Authorized Official

Name: MR. CHESTER POPOILKOWSKI
Title or Position: PRESIDENT
Credential:
Phone: 716-341-5372