Healthcare Provider Details

I. General information

NPI: 1619906344
Provider Name (Legal Business Name): SARATOGA EMERGENCY CORP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 WEST AVE
SARATOGA SPRINGS NY
12866-5902
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027
US

V. Phone/Fax

Practice location:
  • Phone: 518-584-2109
  • Fax: 518-584-2109
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 Number10576
License Number StateNY

VIII. Authorized Official

Name: CLARK HAYWARD
Title or Position: PRESIDENT
Credential:
Phone: 518-584-2109