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General NPI Number Information
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NPI Number | 1942290408
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Entity Type | Organization
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Legal Business Name | NATURAL BRIDGE VOLUNTEER AMBULANCE, INC.
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Dates
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Enumeration Date | 10/26/2005
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Last Update Date | 05/20/2017
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Provider Practice Location Address
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Address Line | 2750 HIGH STREET
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City | NATURAL BRIDGE
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State | NY
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Zip | 13665-1111
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Country | US
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Telephone | 315-644-9898
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Fax | 315-644-4444
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Provider Business Mailing Address
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Address Line | PO BOX 263 27570 HIGH STREET
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City | NATURAL BRIDGE
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State | NY
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Zip | 13665
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Country | US
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Telephone | 315-644-9898
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Fax | 315-644-4444
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Authorized Official
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Title or Position | EMS CHIEF
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Name | MOLLY JO MANUEL
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Credential |
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Telephone | 315-644-9898
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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 | 0722
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License Number State | NY
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