Provider Demographics
NPI:1922456649
Name:GREENVILLE TOWNSHIP VOLUNTEER AMBULANCE CORPS INC
Entity Type:Organization
Organization Name:GREENVILLE TOWNSHIP VOLUNTEER AMBULANCE CORPS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENTWISTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-858-0954
Mailing Address - Street 1:5530 SHERIDAN DR
Mailing Address - Street 2:SUITE 3B
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-3730
Mailing Address - Country:US
Mailing Address - Phone:716-504-3350
Mailing Address - Fax:716-634-7170
Practice Address - Street 1:1495 GREENVILLE TURNPIKE
Practice Address - Street 2:
Practice Address - City:PORT JERVIS
Practice Address - State:NY
Practice Address - Zip Code:12771
Practice Address - Country:US
Practice Address - Phone:845-858-0954
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-03
Last Update Date:2016-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY326453416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport