Provider Demographics
NPI:1609015213
Name:VILLAGE OF SCOTTSVILLE
Entity Type:Organization
Organization Name:VILLAGE OF SCOTTSVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:JARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-889-6050
Mailing Address - Street 1:22 MAIN ST
Mailing Address - Street 2:PO BOX 36
Mailing Address - City:SCOTTSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14546-1316
Mailing Address - Country:US
Mailing Address - Phone:585-889-6050
Mailing Address - Fax:585-889-2505
Practice Address - Street 1:385 SCOTTSVILLE MUMFORD RD
Practice Address - Street 2:
Practice Address - City:SCOTTSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14546-9712
Practice Address - Country:US
Practice Address - Phone:585-889-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08753416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ300000103Medicare PIN