=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558058891
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MADISON COUNTY EMS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/18/2023
-----------------------------------------------------
Last Update Date | 03/31/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 138 N COURT ST
-----------------------------------------------------
City | WAMPSVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13163-7714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-366-2788
-----------------------------------------------------
Fax | 315-635-3289
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 535
-----------------------------------------------------
City | BALDWINSVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13027-0535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COUNTY ADMINISTRATOR
-----------------------------------------------------
Name | MARK SCIMONE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 315-366-2788
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------