Provider Demographics
NPI:1790847770
Name:R.B. LAWRENCE INC.
Entity Type:Organization
Organization Name:R.B. LAWRENCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:B
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:315-375-8258
Mailing Address - Street 1:21 OSWEGO ST
Mailing Address - Street 2:PO BOX 535
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:800-927-5845
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:5747 US HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:NY
Practice Address - Zip Code:13617
Practice Address - Country:US
Practice Address - Phone:315-386-3909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY44413416L0300X
NYD376796343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00879290Medicaid
NY30898BMedicare PIN