Provider Demographics
NPI:1558407551
Name:CANDOR EMERGENCY SQUAD INC
Entity Type:Organization
Organization Name:CANDOR EMERGENCY SQUAD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:CURTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-659-5529
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:800-927-5845
Mailing Address - Fax:
Practice Address - Street 1:58 MAIN ST
Practice Address - Street 2:
Practice Address - City:CANDOR
Practice Address - State:NY
Practice Address - Zip Code:13743-0141
Practice Address - Country:US
Practice Address - Phone:607-659-5529
Practice Address - Fax:607-659-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2023-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X, 3416L0300X
NY124293416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02313519Medicaid
NY02313519Medicaid