Organization
LAKESHORE VOLUNTEER AMBULANCE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE LOCKWOOD (DIRECTOR OF OPERATIONS)
(315) 594-9393
Entity
Organization
Contact information
Practice address
5841 NEW HARTFORD ST, WOLCOTT, NY 14590-1136
(315) 754-6489
(315) 754-8453
Mailing address
8020 E MAIN RD, LE ROY, NY 14482-9704
(585) 768-2192
(585) 768-7323
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
1069
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02773224
—
NY
01
—
590012016
RAILROAD MEDICARE
—
Enumeration date
10/26/2005
Last updated
06/18/2014
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