Healthcare Provider Details

I. General information

NPI: 1376414037
Provider Name (Legal Business Name): TOWN OF MOUNT HOPE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1706 ROUTE 211
OTISVILLE NY
10963-2711
US

IV. Provider business mailing address

8610 MAIN ST
WILLIAMSVILLE NY
14221-7455
US

V. Phone/Fax

Practice location:
  • Phone: 845-386-2211
  • Fax: 845-386-1100
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 Number
License Number State

VIII. Authorized Official

Name: PAUL J. RICKARD
Title or Position: SUPERVISOR
Credential:
Phone: 845-386-2211