Healthcare Provider Details

I. General information

NPI: 1508953712
Provider Name (Legal Business Name): ALPHA AMBULETTE SERVICE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 EDISON AVE
MT VERNON NY
10550-5006
US

IV. Provider business mailing address

110 EDISON AVE
MT VERNON NY
10550-5006
US

V. Phone/Fax

Practice location:
  • Phone: 914-667-8176
  • Fax: 914-667-8307
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number31480
License Number StateNY

VIII. Authorized Official

Name: CRAIG VORSELEN
Title or Position: PRESIDENT
Credential:
Phone: 914-667-8176