Provider Demographics
NPI:1750482758
Name:LEWIS COUNTY SEARCH AND RESCUE INC
Entity Type:Organization
Organization Name:LEWIS COUNTY SEARCH AND RESCUE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEAVERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-376-7745
Mailing Address - Street 1:PO BOX 247
Mailing Address - Street 2:
Mailing Address - City:LOWVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13367-0247
Mailing Address - Country:US
Mailing Address - Phone:315-376-7745
Mailing Address - Fax:315-376-5513
Practice Address - Street 1:7782 WEST STATE ST
Practice Address - Street 2:
Practice Address - City:LOWVILLE
Practice Address - State:NY
Practice Address - Zip Code:13367-0247
Practice Address - Country:US
Practice Address - Phone:315-376-7745
Practice Address - Fax:315-376-5513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12469341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01080051Medicaid
NY52116BMedicare ID - Type Unspecified