Provider Demographics
NPI:1114173697
Name:CORNWALL VOLUNTEER AMBULANCE CORPS
Entity Type:Organization
Organization Name:CORNWALL VOLUNTEER AMBULANCE CORPS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-629-6958
Mailing Address - Street 1:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-0151
Mailing Address - Country:US
Mailing Address - Phone:845-534-9510
Mailing Address - Fax:
Practice Address - Street 1:1 CLINTON ST
Practice Address - Street 2:
Practice Address - City:CORNWALL
Practice Address - State:NY
Practice Address - Zip Code:12518-1501
Practice Address - Country:US
Practice Address - Phone:845-534-9510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY123583416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport