Provider Demographics
NPI:1346418522
Name:CANTERBURY COACH
Entity Type:Organization
Organization Name:CANTERBURY COACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLESPIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-534-3400
Mailing Address - Street 1:PO BOX 228
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:NY
Mailing Address - Zip Code:12518-0228
Mailing Address - Country:US
Mailing Address - Phone:845-534-3400
Mailing Address - Fax:845-220-2179
Practice Address - Street 1:815 BLOOMING GROVE TRPKE
Practice Address - Street 2:SUITE 4
Practice Address - City:NEW WINDSER
Practice Address - State:NY
Practice Address - Zip Code:12553
Practice Address - Country:US
Practice Address - Phone:845-534-3400
Practice Address - Fax:845-220-2179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport