Provider Demographics
NPI:1225183486
Name:TOWN OF ASHLAND AMBULANCE SERVICE
Entity Type:Organization
Organization Name:TOWN OF ASHLAND AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-734-3636
Mailing Address - Street 1:PO BOX 129
Mailing Address - Street 2:TOWN OF ASHLAND
Mailing Address - City:ASHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12407-0129
Mailing Address - Country:US
Mailing Address - Phone:518-734-3636
Mailing Address - Fax:518-734-5834
Practice Address - Street 1:12094 ROUTE 23
Practice Address - Street 2:TOWN OF ASHLAND
Practice Address - City:ASHLAND
Practice Address - State:NY
Practice Address - Zip Code:12407-0129
Practice Address - Country:US
Practice Address - Phone:518-734-3636
Practice Address - Fax:518-734-5834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105413416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02672140Medicaid
NYA65231Medicare ID - Type UnspecifiedAMBULANCE SERVICE