Provider Demographics
NPI:1841273026
Name:CAZENOVIA AREA VOLUNTEER AMBULANCE CORPS INC
Entity type:Organization
Organization Name:CAZENOVIA AREA VOLUNTEER AMBULANCE CORPS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-655-0300
Mailing Address - Street 1:892 NEW CASTLE RD
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-4228
Mailing Address - Country:US
Mailing Address - Phone:800-280-5974
Mailing Address - Fax:724-234-4703
Practice Address - Street 1:106 NELSON ST
Practice Address - Street 2:
Practice Address - City:CAZENOVIA
Practice Address - State:NY
Practice Address - Zip Code:13035
Practice Address - Country:US
Practice Address - Phone:315-655-9798
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-22
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09580341600000X
3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
38441BOtherMEDICARE
NY01793571Medicaid
590012586OtherPALMETTO GBA-RAILROAD