MEDICARE: A-1 AMBULETTE, 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	343900000X	Non-emergency Medical Transport (VAN)	29258	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

General Provider Information

NPI Number	:	1881924090
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A-1 AMBULETTE, INC.

Provider Business Mailing Address
First Line	:	5202 FLATLANDS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-2321
Country	:	US
Telephone Number	:	718-430-9700
Fax Number	:	718-430-1528

Provider Business Practice Location Address
First Line	:	855 BRUSH AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10465-1808
Country	:	US
Telephone Number	:	718-430-9700
Fax Number	:	718-430-1528

Authorized Official
Title or Position	:	CEO
Name	:	MR. MICHAEL S VATCH
Credential	:	MPA, CCEMTP
Telephone Number	:	718-430-9700

Provider Enumeration Date	:	01/11/2010
Last Update Date	:	01/11/2010

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