Provider Demographics
NPI:1235208927
Name:WHEELERS ACCESSIBLE VANS INC.
Entity Type:Organization
Organization Name:WHEELERS ACCESSIBLE VANS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCRAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-456-6351
Mailing Address - Street 1:PO BOX 786
Mailing Address - Street 2:
Mailing Address - City:GUILDERLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12084-0786
Mailing Address - Country:US
Mailing Address - Phone:518-456-6351
Mailing Address - Fax:518-869-9430
Practice Address - Street 1:2316A WESTERN AVE
Practice Address - Street 2:
Practice Address - City:GUILDERLAND
Practice Address - State:NY
Practice Address - Zip Code:12084
Practice Address - Country:US
Practice Address - Phone:518-456-6351
Practice Address - Fax:518-869-9430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28517343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01748838Medicaid