Provider Demographics
NPI:1548383219
Name:TOWN OF CAIRO AMBULANCE SERVICE
Entity Type:Organization
Organization Name:TOWN OF CAIRO AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUDE
Authorized Official - Middle Name:STANLEY
Authorized Official - Last Name:DUSHANE
Authorized Official - Suffix:
Authorized Official - Credentials:AEMT-I
Authorized Official - Phone:518-622-2786
Mailing Address - Street 1:PO BOX 728
Mailing Address - Street 2:512 MAIN ST.
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-0728
Mailing Address - Country:US
Mailing Address - Phone:518-622-2786
Mailing Address - Fax:518-622-3940
Practice Address - Street 1:HIGHWAY COMPLEX ROUTE 145
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:NY
Practice Address - Zip Code:12413
Practice Address - Country:US
Practice Address - Phone:518-622-2357
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-09
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10988341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA29901Medicare ID - Type Unspecified