Healthcare Provider Details

I. General information

NPI: 1164467528
Provider Name (Legal Business Name): ST. JOHNSVILLE AREA VOLUNTEER AMBULANCE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WASHINGTON ST
ST JOHNSVILLE NY
13452-1138
US

IV. Provider business mailing address

PO BOX 535
BALDWINSVILLE NY
13027-0535
US

V. Phone/Fax

Practice location:
  • Phone: 518-857-7656
  • Fax: 518-568-5499
Mailing address:
  • Phone: 800-927-5845
  • Fax: 315-635-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2814
License Number StateNY

VIII. Authorized Official

Name: MRS. MICHAEL SWARTZ
Title or Position: OPERATIONS DIRECTOR
Credential:
Phone: 518-568-5499