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General NPI Number Information
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NPI Number | 1760895379
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Entity Type | Organization
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Legal Business Name | LEWISBORO VOLUNTEER AMBULANCE CORPS, INC
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Dates
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Enumeration Date | 06/11/2014
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Last Update Date | 06/18/2014
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Provider Practice Location Address
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Address Line | 777 ROUTE 35
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City | CROSS RIVER
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State | NY
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Zip | 10518-1147
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Country | US
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Telephone | 914-763-3574
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Fax |
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Provider Business Mailing Address
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Address Line | 777 RT 35 P.O. BOX 41
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City | SOUTH SALEM
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State | NY
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Zip | 10590-0041
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Country | US
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Telephone | 914-763-3574
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | DOUGLAS E. HUX
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Credential |
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Telephone | 914-763-3574
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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 | 5971
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License Number State | NY
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