Provider Demographics
NPI:1851712632
Name:ISLAND WIDE AMBULETTE SERVICES INC
Entity Type:Organization
Organization Name:ISLAND WIDE AMBULETTE SERVICES INC
Other - Org Name:HEALTH BEAT AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:631-665-0044
Mailing Address - Street 1:100 N CLINTON AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-6446
Mailing Address - Country:US
Mailing Address - Phone:631-665-0044
Mailing Address - Fax:
Practice Address - Street 1:100 N CLINTON AVE
Practice Address - Street 2:
Practice Address - City:BAY SHORE
Practice Address - State:NY
Practice Address - Zip Code:11706-6446
Practice Address - Country:US
Practice Address - Phone:631-665-0044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2013-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01179280Medicaid