Provider Demographics
NPI:1063449338
Name:COUNTY AMBULANCE, INC.
Entity Type:Organization
Organization Name:COUNTY AMBULANCE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-499-2527
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-0752
Mailing Address - Country:US
Mailing Address - Phone:413-499-2527
Mailing Address - Fax:413-442-1535
Practice Address - Street 1:175 WAHCONAH ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-2671
Practice Address - Country:US
Practice Address - Phone:413-499-2527
Practice Address - Fax:413-442-1535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA38863416L0300X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1709623Medicaid
NY00918814OtherMEDICAID
MA700877OtherHARVARD PILGRIM
MA000000022678OtherBOSTON HEALTHPLAN
MA040759OtherBLUE CROSS BLUE SHIELD
MA040759OtherBLUE CROSS BLUE SHIELD