Provider Demographics
NPI:1609960210
Name:ERWAY AMBULANCE SERVICE, INC.
Entity Type:Organization
Organization Name:ERWAY AMBULANCE SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:KINTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-734-5017
Mailing Address - Street 1:2030 COLLEGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:ELMIRA HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:14903-1600
Mailing Address - Country:US
Mailing Address - Phone:607-734-5017
Mailing Address - Fax:607-732-2956
Practice Address - Street 1:2030 COLLEGE AVENUE
Practice Address - Street 2:
Practice Address - City:ELMIRA HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:14903-1600
Practice Address - Country:US
Practice Address - Phone:607-734-5017
Practice Address - Fax:607-732-2956
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2009-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106733416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00320347Medicaid
34421BMedicare ID - Type Unspecified
590015008Medicare ID - Type UnspecifiedRAILROAD MEDICARE