Provider Demographics
NPI:1760417604
Name:WILTON EMERGENCY SQUAD
Entity Type:Organization
Organization Name:WILTON EMERGENCY SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:A
Authorized Official - Last Name:HUGGARD
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:518-886-8117
Mailing Address - Street 1:1 HARRAN LN
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5723
Mailing Address - Country:US
Mailing Address - Phone:518-886-8117
Mailing Address - Fax:518-587-4258
Practice Address - Street 1:1 HARRAN LANE
Practice Address - Street 2:
Practice Address - City:SARTOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866
Practice Address - Country:US
Practice Address - Phone:518-886-8117
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10193341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
319598OtherMVP
10030630OtherCDPHP
9602416OtherGHI
NY01954498Medicaid
590013392OtherPALMETTO GBA RR MEDICARE
NYBB6449Medicare ID - Type Unspecified