MEDICARE: TOWN OF COCHECTON VOLUNTEER AMBULANCE CORPS INC

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	341600000X	Ambulance	10648	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	9632961	OTHER	GHI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	A289772	OTHER	OXFORD

General Provider Information

NPI Number	:	1205921020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWN OF COCHECTON VOLUNTEER AMBULANCE CORPS INC

Provider Business Mailing Address
First Line	:	PO BOX 535
Second Line	:
City	:	BALDWINSVILLE
State	:	NY
Zip	:	13027-0535
Country	:	US
Telephone Number	:	315-635-1789
Fax Number	:	315-635-3289

Provider Business Practice Location Address
First Line	:	70 COUNTY ROUTE 116
Second Line	:
City	:	LAKE HUNTINGTON
State	:	NY
Zip	:	12752-5042
Country	:	US
Telephone Number	:	845-932-8138
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CAROL NEARING
Credential	:
Telephone Number	:	845-866-1024

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	06/05/2023

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