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General NPI Number Information
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NPI Number | 1639844301
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Entity Type | Organization
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Legal Business Name | MIDDLESEX VALLEY VOLUNTEER AMBULANCE SERVICE, INC.
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Dates
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Enumeration Date | 08/13/2021
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 817 STATE ROUTE 245
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City | MIDDLESEX
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State | NY
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Zip | 14507
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Country | US
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Telephone | 585-554-6657
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Fax | 585-554-1073
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Provider Business Mailing Address
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Address Line | 8610 MAIN STREET
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221-7455
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Country | US
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Telephone | 716-704-3350
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Fax | 713-247-5274
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON C. JOHNSON
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Credential |
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Telephone | 585-554-6657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416S0300X
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Taxonomy Name | Water Ambulance
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License Number |
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License Number State |
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