Provider Demographics
NPI:1346698131
Name:AUBURN MEDICAL TRANSPORT COMPANY, INC.
Entity Type:Organization
Organization Name:AUBURN MEDICAL TRANSPORT COMPANY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MINNOE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-237-2814
Mailing Address - Street 1:1540 GRAY RD
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:13160-4100
Mailing Address - Country:US
Mailing Address - Phone:315-237-2814
Mailing Address - Fax:315-253-3166
Practice Address - Street 1:1540 GRAY RD
Practice Address - Street 2:
Practice Address - City:UNION SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:13160-4100
Practice Address - Country:US
Practice Address - Phone:315-237-2814
Practice Address - Fax:315-253-3166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03056420Medicaid