Provider Demographics
NPI:1225183486
Name:TOWN OF ASHLAND AMBULANCE SERVICE
Entity type:Organization
Organization Name:TOWN OF ASHLAND AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TOWN SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:TOMPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-734-3636
Mailing Address - Street 1:PO BOX 535
Mailing Address - Street 2:
Mailing Address - City:BALDWINSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13027-0535
Mailing Address - Country:US
Mailing Address - Phone:800-927-5845
Mailing Address - Fax:315-635-3289
Practice Address - Street 1:12094 ROUTE 23
Practice Address - Street 2:TOWN OF ASHLAND
Practice Address - City:ASHLAND
Practice Address - State:NY
Practice Address - Zip Code:12407-0129
Practice Address - Country:US
Practice Address - Phone:518-734-3636
Practice Address - Fax:518-734-5834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
341600000X
NY105413416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02672140Medicaid
NYA65231Medicare ID - Type UnspecifiedAMBULANCE SERVICE