Provider Demographics
NPI:1700937794
Name:MEDICAL MOTOR SERVICE OF ROCHESTER & MONROE COUNTY, INC.
Entity Type:Organization
Organization Name:MEDICAL MOTOR SERVICE OF ROCHESTER & MONROE COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-654-6030
Mailing Address - Street 1:608 CLINTON AVE S
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-1349
Mailing Address - Country:US
Mailing Address - Phone:585-654-6030
Mailing Address - Fax:585-654-5628
Practice Address - Street 1:608 CLINTON AVE S
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-1349
Practice Address - Country:US
Practice Address - Phone:585-654-6030
Practice Address - Fax:585-654-5628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31562343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00814457Medicaid