Provider Demographics
NPI:1801897988
Name:EDWARDS AMBULANCE INC
Entity type:Organization
Organization Name:EDWARDS AMBULANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-737-7657
Mailing Address - Street 1:3440 ONEIDA ST
Mailing Address - Street 2:
Mailing Address - City:CHADWICKS
Mailing Address - State:NY
Mailing Address - Zip Code:13319-3405
Mailing Address - Country:US
Mailing Address - Phone:315-737-7657
Mailing Address - Fax:315-737-7906
Practice Address - Street 1:3440 ONEIDA ST
Practice Address - Street 2:
Practice Address - City:CHADWICKS
Practice Address - State:NY
Practice Address - Zip Code:13319-3405
Practice Address - Country:US
Practice Address - Phone:315-737-7657
Practice Address - Fax:315-737-7906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01045876Medicaid
NY3225OtherDEPT. OF HEALTH
NY01045876Medicaid