Organization
SOUTHEAST QUADRANT MOBILE CRITICAL CARE UNIT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANN NICHOLS (PRESIDENT)
(585) 218-0026
Entity
Organization
Contact information
Practice address
25247 BAIRD ROAD, PENFILED, NY 14526-2332
(585) 218-0025
(585) 218-0025
Mailing address
5530 SHERIDAN DR, SUITE 3B, WILLIAMSVILLE, NY 14221-3730
(716) 204-3350
(716) 634-7170
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
2797
NY
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
590015041
MEDICARE RAILROAD
NY
01
—
PSEQUADMOBIL
MONROE PLAN
NY
Enumeration date
02/28/2006
Last updated
12/16/2016
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