MEDICARE: CAZENOVIA AREA 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	09580	NY
2	3416L0300X	Land Ambulance

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38441B	OTHER		MEDICARE

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
3	590012586	OTHER		PALMETTO GBA-RAILROAD

General Provider Information

NPI Number	:	1841273026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAZENOVIA AREA VOLUNTEER AMBULANCE CORPS INC

Provider Business Mailing Address
First Line	:	892 NEW CASTLE RD
Second Line	:
City	:	SLIPPERY ROCK
State	:	PA
Zip	:	16057-4228
Country	:	US
Telephone Number	:	800-280-5974
Fax Number	:	724-234-4703

Provider Business Practice Location Address
First Line	:	106 NELSON ST
Second Line	:
City	:	CAZENOVIA
State	:	NY
Zip	:	13035
Country	:	US
Telephone Number	:	315-655-9798
Fax Number	:

Authorized Official
Title or Position	:	TREASURER
Name	:	MR. DENNIS GOLDMANN
Credential	:
Telephone Number	:	315-655-0300

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	04/08/2024

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