Organization
UPPER DELAWARE AMBULANCE CORPS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK KNACK (PRESIDENT)
(845) 887-6070
Entity
Organization
Contact information
Practice address
26 KELLAM BRIDGE RD, HANKINS, NY 12741-5002
(315) 635-1789
Mailing address
PO BOX 535, BALDWINSVILLE, NY 13027-0535
(315) 635-1789
(315) 635-3289
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
10005
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01812106
—
NY
01
—
4190489
MVP
—
01
—
590013548
PALMETTO GBA RR MEDICARE
—
01
—
9611703
GHI
—
Enumeration date
07/03/2006
Last updated
12/12/2011
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