Provider Demographics
NPI:1700862703
Name:CATO IRA MERIDIAN VICTORY AMBULANCE CORPS INC
Entity Type:Organization
Organization Name:CATO IRA MERIDIAN VICTORY AMBULANCE CORPS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:L
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EPPRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-626-3334
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:315-635-1789
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:2496 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CATO
Practice Address - State:NY
Practice Address - Zip Code:13033-3171
Practice Address - Country:US
Practice Address - Phone:315-626-3334
Practice Address - Fax:315-626-3699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-21
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09818341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
490003531OtherPALMETTO GBA RAILROAD
319943OtherMVP
NY01678115Medicaid
319943OtherMVP