MEDICARE: THE ROCK 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	3416L0300X	Land Ambulance	0689	NY

General Provider Information

NPI Number	:	1518291095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ROCK VOLUNTEER AMBULANCE CORPS INC.

Provider Business Mailing Address
First Line	:	510 BEACH 20TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3622
Country	:	US
Telephone Number	:	718-327-2865
Fax Number	:

Provider Business Practice Location Address
First Line	:	510 BEACH 20TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-3622
Country	:	US
Telephone Number	:	718-327-2865
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	MR. WILLIAM HEATH
Credential	:
Telephone Number	:	718-327-2865

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	09/30/2009

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