Provider Demographics
NPI:1891177739
Name:CNY MEDICAL TRANSPORTATION
Entity Type:Organization
Organization Name:CNY MEDICAL TRANSPORTATION
Other - Org Name:KIMBERLY WALRATH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-267-6975
Mailing Address - Street 1:2595 COUNTY HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:SCHENEVUS
Mailing Address - State:NY
Mailing Address - Zip Code:12155-2405
Mailing Address - Country:US
Mailing Address - Phone:607-267-6975
Mailing Address - Fax:
Practice Address - Street 1:2595 COUNTY HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:SCHENEVUS
Practice Address - State:NY
Practice Address - Zip Code:12155-2405
Practice Address - Country:US
Practice Address - Phone:607-267-6975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY545445343344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi