Provider Demographics
NPI:1043249055
Name:S&S VOLUNTEEER AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:S&S VOLUNTEEER AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:JENISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-429-3355
Mailing Address - Street 1:5530 SHERIDAN DR
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3730
Mailing Address - Country:US
Mailing Address - Phone:716-204-3350
Mailing Address - Fax:716-634-7170
Practice Address - Street 1:75 N HELMER AVE
Practice Address - Street 2:
Practice Address - City:DOLGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:13329-1128
Practice Address - Country:US
Practice Address - Phone:315-429-3355
Practice Address - Fax:315-429-9312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-02
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY17143416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01743466Medicaid
NYJ300009210Medicare PIN