Provider Demographics
NPI:1568450005
Name:TRI-TOWN VOLUNTEER RESCUE SQUAD, INC.
Entity Type:Organization
Organization Name:TRI-TOWN VOLUNTEER RESCUE SQUAD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:HARTFORD
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:315-705-5588
Mailing Address - Street 1:8610 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7455
Mailing Address - Country:US
Mailing Address - Phone:716-204-3350
Mailing Address - Fax:716-247-5274
Practice Address - Street 1:900 STATE HIGHWAY 11C
Practice Address - Street 2:
Practice Address - City:BRASHER FALLS
Practice Address - State:NY
Practice Address - Zip Code:13613
Practice Address - Country:US
Practice Address - Phone:315-389-5731
Practice Address - Fax:315-389-8100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY44533416L0300X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01522710Medicaid
590009316OtherRAILROAD MEDICARE