=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386008365
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COUNTY CABS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2016
-----------------------------------------------------
Last Update Date | 04/06/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12 HORTON ST
-----------------------------------------------------
City | HORNELL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14843-1452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-324-0000
-----------------------------------------------------
Fax | 607-324-0060
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12 HORTON ST
-----------------------------------------------------
City | HORNELL
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 14843-1452
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 607-324-0000
-----------------------------------------------------
Fax | 607-324-0060
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CO-OWNER
-----------------------------------------------------
Name | DOROTHY CODDINGTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 607-324-0000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 343900000X
-----------------------------------------------------
Taxonomy Name | Non-emergency Medical Transport (VAN)
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 344600000X
-----------------------------------------------------
Taxonomy Name | Taxi
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------