Provider Demographics
NPI:1760143200
Name:CHERRY VALLEY FIRE DEPARTMENT, EMERGENCY SQUAD
Entity Type:Organization
Organization Name:CHERRY VALLEY FIRE DEPARTMENT, EMERGENCY SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:COLANDREA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-264-8221
Mailing Address - Street 1:PO BOX 504
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:13320-0504
Mailing Address - Country:US
Mailing Address - Phone:607-264-8221
Mailing Address - Fax:
Practice Address - Street 1:11 RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:NY
Practice Address - Zip Code:13320-1332
Practice Address - Country:US
Practice Address - Phone:607-264-8221
Practice Address - Fax:607-264-3580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-06
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance