Provider Demographics
NPI:1225809593
Name:EDAMAR AMBULETTE TRANSPPORT LLC
Entity Type:Organization
Organization Name:EDAMAR AMBULETTE TRANSPPORT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUCIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-729-3508
Mailing Address - Street 1:PO BOX 82
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10949-0082
Mailing Address - Country:US
Mailing Address - Phone:845-587-7962
Mailing Address - Fax:
Practice Address - Street 1:1204 LAKES RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-4220
Practice Address - Country:US
Practice Address - Phone:845-729-3508
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)