Healthcare Provider Details

I. General information

NPI: 1326021502
Provider Name (Legal Business Name): AMBER AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2005
Last Update Date: 06/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 AMBER RD
MARIETTA NY
13110-3103
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 315-636-8283
  • Fax:
Mailing address:
  • Phone: 315-635-1789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number09848
License Number StateNY

VIII. Authorized Official

Name: MR. DOUGLAS LAFRANCE
Title or Position: PRESIDENT
Credential:
Phone: 315-636-7745