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General NPI Number Information
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NPI Number | 1235230863
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Entity Type | Organization
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Legal Business Name | WEST GLENS FALLS EMERGENCY SQUAD INC.
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 86 LUZERNE RD
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City | QUEENSBURY
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State | NY
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Zip | 12804-3327
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Country | US
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Telephone | 518-798-5011
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 676
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City | GLENS FALLS
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State | NY
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Zip | 12801-0676
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Country | US
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Telephone | 888-603-2455
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Fax | 888-603-2455
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SANDY J BOUCHER
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Credential |
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Telephone | 888-603-2455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 5623
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License Number State | NY
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