Provider Demographics
NPI:1295218360
Name:CMS TRANSPORT OF WESTERN NY LLC
Entity Type:Organization
Organization Name:CMS TRANSPORT OF WESTERN NY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMALDONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-362-5877
Mailing Address - Street 1:60 ENDICAR DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14622-1774
Mailing Address - Country:US
Mailing Address - Phone:585-698-9357
Mailing Address - Fax:
Practice Address - Street 1:60 ENDICAR DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14622-1774
Practice Address - Country:US
Practice Address - Phone:585-698-9357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-13
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)