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General NPI Number Information
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NPI Number | 1043448905
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Entity Type | Organization
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Legal Business Name | BELLE-ROCK OF BEACH CHANNEL INC.
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 06/30/2009
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Provider Practice Location Address
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Address Line | 11404 BEACH CHANNEL DR
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2220
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Country | US
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Telephone | 718-945-5555
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Fax | 718-945-7738
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Provider Business Mailing Address
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Address Line | 11404 BEACH CHANNEL DR
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2220
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Country | US
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Telephone | 718-945-5555
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Fax | 718-945-7738
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAM GROSMAN
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Credential |
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Telephone | 718-945-5555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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