MEDICARE: LANCASTER 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	1484	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1730179128	OTHER		MEDICARE
2	590007543	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1730179128
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LANCASTER VOLUNTEER AMBULANCE CORPS, INC.

Provider Business Mailing Address
First Line	:	8610 MAIN STREET
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	:	40 EMBRY PLACE
Second Line	:
City	:	LANCASTER
State	:	NY
Zip	:	14086-1703
Country	:	US
Telephone Number	:	716-683-3282
Fax Number	:	716-683-5466

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. CHESTER POPOILKOWSKI
Credential	:
Telephone Number	:	716-341-5372

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	11/07/2024

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