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General NPI Number Information
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NPI Number | 1255634606
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Entity Type | Organization
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Legal Business Name | 342-ABUS
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Dates
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Enumeration Date | 12/07/2010
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Last Update Date | 12/31/2010
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Provider Practice Location Address
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Address Line | 389 COUNTY ROUTE 1A
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City | OSWEGO
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State | NY
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Zip | 13126-5931
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Country | US
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Telephone | 315-342-2287
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 59
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City | MEXICO
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State | NY
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Zip | 13114-0059
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Country | US
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Telephone | 315-342-2287
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Fax | 866-247-3844
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ALLEN CHASE
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Credential |
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Telephone | 315-342-2287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number | 38054
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number | 38054
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License Number State | NY
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