Healthcare Provider Details

I. General information

NPI: 1013975994
Provider Name (Legal Business Name): PHELPS AMBULANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 04/27/2025
Certification Date: 04/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

79 ONTARIO STREET
PHELPS NY
14532-0000
US

IV. Provider business mailing address

8610 MAIN STREET
WILLIAMSVILLE NY
14221-7455
US

V. Phone/Fax

Practice location:
  • Phone: 315-548-3862
  • Fax: 315-548-2552
Mailing address:
  • Phone: 716-204-3350
  • Fax: 716-247-5274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number10182
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: PHILIP CHARLES FRERE JR.
Title or Position: TREASURER
Credential:
Phone: 315-548-3862