MEDICARE: SLOATSBURG COMMUNITY 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215979760
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLOATSBURG COMMUNITY AMBULANCE CORPS, INC

Provider Business Mailing Address
First Line	:	PO BOX 527
Second Line	:
City	:	ORANGEBURG
State	:	NY
Zip	:	10962-0527
Country	:	US
Telephone Number	:	610-401-2041
Fax Number	:	610-401-2100

Provider Business Practice Location Address
First Line	:	62 WASHINGTON AVE
Second Line	:
City	:	SLOATSBURG
State	:	NY
Zip	:	10974-1718
Country	:	US
Telephone Number	:	845-753-2445
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MATTHEW GANNON
Credential	:
Telephone Number	:	845-753-2445

Provider Enumeration Date	:	06/11/2006
Last Update Date	:	10/23/2012

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