MEDICARE: CHESTER VOLUNTEER AMBULANCE CORP

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	10064	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	590011895	OTHER	NY	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1770541591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHESTER VOLUNTEER AMBULANCE CORP

Provider Business Mailing Address
First Line	:	PO BOX 246
Second Line	:
City	:	CHESTER
State	:	NY
Zip	:	10918-0246
Country	:	US
Telephone Number	:	845-469-4487
Fax Number	:	845-294-9656

Provider Business Practice Location Address
First Line	:	79 LAROE RD
Second Line	:
City	:	CHESTER
State	:	NY
Zip	:	10918-1484
Country	:	US
Telephone Number	:	845-469-4487
Fax Number	:	845-294-9656

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ALEX TORO
Credential	:
Telephone Number	:	845-469-4487

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	05/01/2012

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