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General NPI Number Information
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NPI Number | 1962490409
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Entity Type | Organization
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Legal Business Name | TOWN OF HOOSICK RESCUE SQUAD, INC
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Dates
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Enumeration Date | 10/10/2005
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Last Update Date | 09/10/2025
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Provider Practice Location Address
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Address Line | 21 FIRST STREET
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City | HOOSICK FALLS
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State | NY
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Zip | 12090
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Country | US
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Telephone | 518-686-4105
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Fax | 315-635-3289
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Provider Business Mailing Address
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Address Line | PO BOX 787
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City | LATHAM
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State | NY
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Zip | 12110-0787
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Country | US
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Telephone | 888-603-2455
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Fax |
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Authorized Official
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Title or Position | CHIEF OF OPERATIONS
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Name | MR. JOHN CLARKSON KERVIN II
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Credential | AEMT
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Telephone | 518-686-4106
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 4125
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License Number State | NY
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