Provider Demographics
NPI:1659316669
Name:CENTRAL ONEIDA COUNTY VOLUNTEER AMBULANCE CORPS.
Entity Type:Organization
Organization Name:CENTRAL ONEIDA COUNTY VOLUNTEER AMBULANCE CORPS.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DZWONKAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-853-2118
Mailing Address - Street 1:892 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-4228
Mailing Address - Country:US
Mailing Address - Phone:800-280-5974
Mailing Address - Fax:724-794-1633
Practice Address - Street 1:7489 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NY
Practice Address - Zip Code:13323-3718
Practice Address - Country:US
Practice Address - Phone:315-853-2118
Practice Address - Fax:315-853-2611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY955362OtherMOHAWH VALLEY PHYSICAN
NY1644146Medicaid
NY01644146Medicaid
NY955362OtherMOHAWH VALLEY PHYSICAN