MEDICARE: CORTLANDT COMMUNITY 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	09586	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	351023	OTHER	MVP
3	3200227	OTHER	GHI
4	590014042	OTHER	PALMETTO GBA-RAILROAD

General Provider Information

NPI Number	:	1699758755
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CORTLANDT COMMUNITY 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	:	6 KINGS FERRY RD
Second Line	:
City	:	MONTROSE
State	:	NY
Zip	:	10548-1406
Country	:	US
Telephone Number	:	914-739-0881
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	KEITH RAPPING
Credential	:
Telephone Number	:	914-739-0881

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	12/31/2025

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