MEDICARE: ONTARIO VOLUNTEER EMERGENCY SQUAD

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	5820	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	PONTVOLEMSQ	OTHER	NY	MONROE PLAN

General Provider Information

NPI Number	:	1881660736
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONTARIO VOLUNTEER EMERGENCY SQUAD

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	:	6132 FURNACE ROAD
Second Line	:
City	:	ONTARIO
State	:	NY
Zip	:	14519-8973
Country	:	US
Telephone Number	:	315-524-5751
Fax Number	:

Authorized Official
Title or Position	:	BOARD MEMBER
Name	:	CAITLIN WOOD
Credential	:
Telephone Number	:	585-713-9211

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	12/16/2022

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Directions to “ONTARIO VOLUNTEER EMERGENCY SQUAD ” Practice Location

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