Healthcare Provider Details

I. General information

NPI: 1073571717
Provider Name (Legal Business Name): PERRY EMERGENCY AMBULANCE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 05/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 MILL ST
PERRY NY
14530-1510
US

IV. Provider business mailing address

11 MILL ST
PERRY NY
14530-1510
US

V. Phone/Fax

Practice location:
  • Phone: 585-237-2520
  • Fax: 585-237-2520
Mailing address:
  • Phone: 585-237-2520
  • Fax: 585-237-2520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number06016
License Number StateNY

VIII. Authorized Official

Name: DARCY CONAWAY
Title or Position: BUSINESS MANAGER
Credential: EMT
Phone: 585-237-2520