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General NPI Number Information
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NPI Number | 1699950501
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Entity Type | Organization
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Legal Business Name | TOWN OF WATERTOWN AMBULANCE SERVICE INC
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 04/02/2013
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Provider Practice Location Address
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Address Line | 18535 NYS RT. 11
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City | WATERTOWN
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State | NY
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Zip | 13601
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Country | US
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Telephone | 315-782-5999
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Fax | 315-782-5998
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Provider Business Mailing Address
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Address Line | PO BOX 170
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City | WATERTOWN
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State | NY
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Zip | 13601-0170
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Country | US
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Telephone | 315-782-5999
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Fax | 315-782-5998
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DAVID ROOF
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Credential |
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Telephone | 315-782-8828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 12753
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License Number State | NY
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