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General NPI Number Information
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NPI Number | 1700874658
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Entity Type | Organization
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Legal Business Name | AUSABLE FORKS VOLUNTEER AMBULANCE SERVICE CORPORATION
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 23 SCHOOL LANE
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City | AUSABLE FORKS
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State | NY
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Zip | 12912-0835
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Country | US
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Telephone | 518-647-8860
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Fax | 518-647-5749
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Provider Business Mailing Address
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Address Line | 8020 E MAIN RD
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City | LE ROY
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State | NY
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Zip | 14482-9704
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Country | US
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Telephone | 585-768-2192
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Fax | 585-768-7323
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Authorized Official
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Title or Position | CHIEF OPERATIONS OFFICER
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Name | MR. COREY CRAHAN
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Credential |
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Telephone | 888-603-2455
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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 | 1529
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License Number State | NY
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