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General NPI Number Information
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NPI Number | 1588037451
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Entity Type | Organization
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Legal Business Name | M&B AMBULETTE SERVICES, LLC
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Dates
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Enumeration Date | 11/02/2015
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Last Update Date | 11/02/2015
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Provider Practice Location Address
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Address Line | 5501 GRAVES RD
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City | GALWAY
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State | NY
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Zip | 12074-2303
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Country | US
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Telephone | 518-242-6896
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Fax |
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Provider Business Mailing Address
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Address Line | 5501 GRAVES RD
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City | GALWAY
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State | NY
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Zip | 12074-2303
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Country | US
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Telephone | 518-242-6896
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Fax |
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Authorized Official
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Title or Position | PARTNER/ MANAGING EMPLOYEE
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Name | MONIQUE L OLSEN
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Credential |
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Telephone | 518-242-6896
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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 | 470300421
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License Number State | NY
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