Provider Demographics
NPI:1407837834
Name:BROOME VOLUNTEER EMERGENCY SQUAD INC
Entity Type:Organization
Organization Name:BROOME VOLUNTEER EMERGENCY SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-772-6565
Mailing Address - Street 1:PO BOX 29895
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-9895
Mailing Address - Country:US
Mailing Address - Phone:855-978-6303
Mailing Address - Fax:888-965-4620
Practice Address - Street 1:261 COURT ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-3602
Practice Address - Country:US
Practice Address - Phone:855-978-6303
Practice Address - Fax:888-965-4620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-11
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY91091341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01011985Medicaid
590009931OtherRAILROAD MEDICARE
NY01011985Medicaid