Provider Demographics
NPI:1881660736
Name:ONTARIO VOLUNTEER EMERGENCY SQUAD
Entity Type:Organization
Organization Name:ONTARIO VOLUNTEER EMERGENCY SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CAITLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-713-9211
Mailing Address - Street 1:8610 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7455
Mailing Address - Country:US
Mailing Address - Phone:716-204-3350
Mailing Address - Fax:716-247-5274
Practice Address - Street 1:6132 FURNACE ROAD
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:NY
Practice Address - Zip Code:14519-8973
Practice Address - Country:US
Practice Address - Phone:315-524-5751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58203416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01709860Medicaid
NYPONTVOLEMSQOtherMONROE PLAN
NY01709860Medicaid