Provider Demographics
NPI:1609637305
Name:TOWN OF KNOX OFFICE OF SUPERVISOR
Entity Type:Organization
Organization Name:TOWN OF KNOX OFFICE OF SUPERVISOR
Other - Org Name:TOWN OF KNOX
Other - Org Type:Other Name
Authorized Official - Title/Position:EMS DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:S
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:888-603-2455
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-0787
Mailing Address - Country:US
Mailing Address - Phone:888-603-2455
Mailing Address - Fax:
Practice Address - Street 1:200 CENTRE DR
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-4472
Practice Address - Country:US
Practice Address - Phone:518-356-1501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance