Provider Demographics
NPI:1093891756
Name:COUNTY RAINBOW TAXI, INC.
Entity Type:Organization
Organization Name:COUNTY RAINBOW TAXI, INC.
Other - Org Name:CENTRAL BERKSHIRE AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:RENZI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-447-3800
Mailing Address - Street 1:10 PLEASANT ST
Mailing Address - Street 2:P.O. BOX 642
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-0642
Mailing Address - Country:US
Mailing Address - Phone:413-447-3800
Mailing Address - Fax:413-443-8600
Practice Address - Street 1:10 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4831
Practice Address - Country:US
Practice Address - Phone:413-447-3800
Practice Address - Fax:413-443-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3883341600000X
MA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02697932Medicaid
MA0006691Medicaid
MA1711881Medicaid