Provider Demographics
NPI:1649260191
Name:MONROE VOLUNTEER AMBULANCE CORPS INC
Entity type:Organization
Organization Name:MONROE VOLUNTEER AMBULANCE CORPS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-774-3599
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10949-0553
Mailing Address - Country:US
Mailing Address - Phone:845-774-3599
Mailing Address - Fax:
Practice Address - Street 1:100 RAMAPO AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3410
Practice Address - Country:US
Practice Address - Phone:845-774-3599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3416L0300X
NY3521341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
No3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
590011496OtherRAILROAD MEDICARE
NY01712298Medicaid
NY01712298Medicaid