Healthcare Provider Details

I. General information

NPI: 1932482379
Provider Name (Legal Business Name): AMBUCARE INTERSTATE AMBULANCE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 GREAVES LN STE L SUITE 142
STATEN ISLAND NY
10308-2173
US

IV. Provider business mailing address

11 INTEGRA DR SUITE 10
CONCORD NH
03301-5150
US

V. Phone/Fax

Practice location:
  • Phone: 866-535-9948
  • Fax: 877-633-4569
Mailing address:
  • Phone: 866-535-9948
  • Fax: 877-633-4569

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNH

VIII. Authorized Official

Name: MR. ROBERT MARCHAND
Title or Position: PRESIDENT
Credential:
Phone: 866-535-9948