Provider Demographics
NPI:1922004043
Name:NORTH CONWAY AMBULANCE INC.
Entity Type:Organization
Organization Name:NORTH CONWAY AMBULANCE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-356-5248
Mailing Address - Street 1:PO BOX 2787
Mailing Address - Street 2:
Mailing Address - City:NORTH CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03860-2787
Mailing Address - Country:US
Mailing Address - Phone:603-356-5248
Mailing Address - Fax:603-356-8738
Practice Address - Street 1:185 VALLEY VW
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-5138
Practice Address - Country:US
Practice Address - Phone:603-356-5248
Practice Address - Fax:603-356-8738
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00853416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH80596260Medicaid
NHNH9650Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER