Provider Demographics
NPI:1881639219
Name:MID-COUNTY VOLUNTEER AMBULANCE SERVICE NY INC.
Entity Type:Organization
Organization Name:MID-COUNTY VOLUNTEER AMBULANCE SERVICE NY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-673-2039
Mailing Address - Street 1:46 WEST GRAND STREET
Mailing Address - Street 2:
Mailing Address - City:PALATINE BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:13428-9701
Mailing Address - Country:US
Mailing Address - Phone:518-673-2039
Mailing Address - Fax:518-673-3106
Practice Address - Street 1:46 W GRAND STRETT
Practice Address - Street 2:
Practice Address - City:PALATINE BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:13428-9701
Practice Address - Country:US
Practice Address - Phone:518-673-2039
Practice Address - Fax:518-673-3106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY28133416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02128701Medicaid
NY02128701Medicaid