Provider Demographics
NPI:1073581484
Name:GREATER AMSTERDAM VOLUNTEER AMBULANCE CORPS, INC
Entity Type:Organization
Organization Name:GREATER AMSTERDAM VOLUNTEER AMBULANCE CORPS, INC
Other - Org Name:GAVAC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:PASQUARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-843-1150
Mailing Address - Street 1:P.O. BOX 11
Mailing Address - Street 2:
Mailing Address - City:AMSTERDAM
Mailing Address - State:NY
Mailing Address - Zip Code:12010
Mailing Address - Country:US
Mailing Address - Phone:518-843-1150
Mailing Address - Fax:518-842-2559
Practice Address - Street 1:24 GARDNER PLACE
Practice Address - Street 2:
Practice Address - City:AMSTERDAM
Practice Address - State:NY
Practice Address - Zip Code:12010
Practice Address - Country:US
Practice Address - Phone:518-843-1150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-10
Last Update Date:2020-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28123416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01410053Medicaid
NY01410053Medicaid