Provider Demographics
NPI:1770541591
Name:CHESTER VOLUNTEER AMBULANCE CORP
Entity type:Organization
Organization Name:CHESTER VOLUNTEER AMBULANCE CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:TORO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-469-4487
Mailing Address - Street 1:PO BOX 246
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10918-0246
Mailing Address - Country:US
Mailing Address - Phone:845-469-4487
Mailing Address - Fax:845-294-9656
Practice Address - Street 1:79 LAROE RD
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:NY
Practice Address - Zip Code:10918-1484
Practice Address - Country:US
Practice Address - Phone:845-469-4487
Practice Address - Fax:845-294-9656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-02
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100643416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY590011895OtherMEDICARE RAILROAD
NY01790514Medicaid
NY01790514Medicaid