Organization
JOHN H AHEARN JR RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY T GENTILE (AUTHORIZED AGENT)
(860) 257-9201
Entity
Organization
Contact information
Practice address
58 N CENTRAL AVE, MECHANICVILLE, NY 12118-1514
(518) 664-8354
(518) 664-8354
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(860) 257-9201
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
4520
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02227645
—
NY
01
—
590014728
RAILROAD MEDICARE
NY
Enumeration date
10/26/2005
Last updated
11/26/2008
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