Provider Demographics
NPI:1093825648
Name:MEDICAL EXPRESS AMBULANCE CORP.
Entity Type:Organization
Organization Name:MEDICAL EXPRESS AMBULANCE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAUINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-617-1522
Mailing Address - Street 1:1028 FREEMAN ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10459-2102
Mailing Address - Country:US
Mailing Address - Phone:718-617-1522
Mailing Address - Fax:718-617-1262
Practice Address - Street 1:1028 FREEMAN ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10459-2102
Practice Address - Country:US
Practice Address - Phone:718-617-1522
Practice Address - Fax:718-617-1262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05733416L0300X
NY34801343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02120212Medicaid
NYA43171Medicare ID - Type Unspecified