=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801879705
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EASTON-GREENWICH RESCUE SQUAD , INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/23/2005
-----------------------------------------------------
Last Update Date | 12/04/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 441 STATE ROUTE 29
-----------------------------------------------------
City | GREENWICH
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 12834-4233
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 518-692-7118
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 535
-----------------------------------------------------
City | BALDWINSVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13027-0535
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-635-1789
-----------------------------------------------------
Fax | 315-635-3289
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CAPTAIN
-----------------------------------------------------
Name | FRANK BROWNELL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 518-695-3187
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | 09473
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------