MEDICARE: CINCINNATUS FIRE DISTRICT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1124736046
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CINCINNATUS FIRE DISTRICT

Provider Business Mailing Address
First Line	:	8610 MAIN ST
Second Line	:
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-7455
Country	:	US
Telephone Number	:	716-204-3350
Fax Number	:	716-247-5274

Provider Business Practice Location Address
First Line	:	2757 NEW YORK STATE ROUTE 26
Second Line	:
City	:	CINCINNATUS
State	:	NY
Zip	:	13040
Country	:	US
Telephone Number	:	607-423-4882
Fax Number	:

Authorized Official
Title or Position	:	CHAIRPERSON
Name	:	TERENA LOOMIS
Credential	:
Telephone Number	:	607-423-4882

Provider Enumeration Date	:	11/09/2022
Last Update Date	:	11/09/2022

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Directions to “CINCINNATUS FIRE DISTRICT ” Practice Location

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