Provider Demographics
NPI:1013417088
Name:PAPA DEE AMBULETTE SERVICE
Entity Type:Organization
Organization Name:PAPA DEE AMBULETTE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROHAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:WRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:917-376-6556
Mailing Address - Street 1:309 FENIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:UNIONDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11553-1514
Mailing Address - Country:US
Mailing Address - Phone:917-376-6556
Mailing Address - Fax:
Practice Address - Street 1:309 FENIMORE AVE
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11553-1514
Practice Address - Country:US
Practice Address - Phone:917-376-6556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)