Provider Demographics
NPI:1376533844
Name:GARRISON VOLUNTEER AMBULANCE CORP
Entity Type:Organization
Organization Name:GARRISON VOLUNTEER AMBULANCE CORP
Other - Org Name:GARRISON VOLUNTEER AMBULANCE FIRST AID SQUAD INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOISELE
Authorized Official - Suffix:
Authorized Official - Credentials:BOARD OF DIRECTORS
Authorized Official - Phone:917-825-1600
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:GARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10524
Mailing Address - Country:US
Mailing Address - Phone:845-424-4401
Mailing Address - Fax:845-424-4167
Practice Address - Street 1:1 BUENA VISTA ROAD
Practice Address - Street 2:
Practice Address - City:GARRISON
Practice Address - State:NY
Practice Address - Zip Code:10524
Practice Address - Country:US
Practice Address - Phone:845-424-4401
Practice Address - Fax:845-424-4167
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3919341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02709424Medicaid
NYA66391Medicare PIN