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General NPI Number Information
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NPI Number | 1679550990
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Entity Type | Organization
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Legal Business Name | GRANVILLE RESCUE SQUAD INC
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 52 E POTTER AVE
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City | GRANVILLE
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State | NY
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Zip | 12832-1620
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Country | US
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Telephone | 518-642-1830
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Fax | 315-635-3289
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Provider Business Mailing Address
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Address Line | PO BOX 535
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City | BALDWINSVILLE
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State | NY
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Zip | 13027-0535
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Country | US
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Telephone | 315-635-1789
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Fax |
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Authorized Official
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Title or Position | ASSISTANT CAPTAIN
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Name | MICHAEL ZINN
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Credential |
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Telephone | 518-642-1830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 10046
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License Number State | NY
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