Organization
SODUS TOWN AMBULANCE CORPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW JAY KING (PRESIDENT)
(315) 483-6531
Entity
Organization
Contact information
Practice address
5496 BRICK SCHOOLHOUSE RD, NORTH ROSE, NY 14516-9765
(315) 706-1209
Mailing address
PO BOX 535, BALDWINSVILLE, NY 13027-0535
(800) 927-5845
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
5828
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04020893
—
NY
01
—
P01469936
RAILROAD MEDICARE
—
Enumeration date
12/12/2013
Last updated
03/03/2023
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