Provider Demographics
NPI:1982963450
Name:KEYSTONE AMERICA, INC.
Entity Type:Organization
Organization Name:KEYSTONE AMERICA, INC.
Other - Org Name:GARNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LOCATION MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VARNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-265-5350
Mailing Address - Street 1:10 LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-1819
Mailing Address - Country:US
Mailing Address - Phone:315-265-5350
Mailing Address - Fax:315-265-0984
Practice Address - Street 1:10 LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-1819
Practice Address - Country:US
Practice Address - Phone:315-265-5350
Practice Address - Fax:315-265-0984
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)