Healthcare Provider Details

I. General information

NPI: 1801886379
Provider Name (Legal Business Name): OGDENSBURG VOLUNTEER RESCUE SQUAD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1223 PICKERING ST.
OGDENSBURG NY
13669
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 315-393-0837
  • Fax: 315-394-0958
Mailing address:
  • Phone: 315-635-1789
  • Fax: 315-635-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number30925
License Number StateNY

VIII. Authorized Official

Name: MR. KENNETH GARDNER
Title or Position: CHIEF
Credential:
Phone: 315-393-0837