Provider Demographics
NPI:1700054632
Name:RAINBOW AMBULETTE SERVICE INC
Entity Type:Organization
Organization Name:RAINBOW AMBULETTE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITMORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-842-7194
Mailing Address - Street 1:510 BEACH AVENUE
Mailing Address - Street 2:PRIVATE HOUSE
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-3019
Mailing Address - Country:US
Mailing Address - Phone:718-589-3470
Mailing Address - Fax:718-842-2266
Practice Address - Street 1:327 SOUNDVIEW AVENUE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-3019
Practice Address - Country:US
Practice Address - Phone:718-842-2000
Practice Address - Fax:718-842-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01427650Medicaid