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General NPI Number Information
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NPI Number | 1699844175
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Entity Type | Organization
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Legal Business Name | RENSSELAER VOLUNTEER AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 12/30/2011
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Provider Practice Location Address
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Address Line | 901 3RD ST
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City | RENSSELAER
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State | NY
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Zip | 12144-2116
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Country | US
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Telephone | 518-427-8515
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Fax |
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Provider Business Mailing Address
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Address Line | 4 CORTLAND DR
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City | ALBANY
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State | NY
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Zip | 12211-1319
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Country | US
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Telephone | 888-603-2455
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Fax | 888-603-2455
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | MR. DEAN MYERS
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Credential |
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Telephone | 518-427-8515
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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 | 4114
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License Number State | NY
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