Organization
COLRAIN VOL AMB ASSOC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY PONCE (CEO/DIRECTOR)
(413) 624-0128
Entity
Organization
Contact information
Practice address
51 MAIN RD, COLRAIN, MA 01340-5501
(413) 624-5528
Mailing address
8 TURCOTTE MEMORIAL DR, ROWLEY, MA 01969-1706
(800) 488-4351
(978) 356-2721
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
3369
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000027770
BMC HEALTHNET PLAN
—
01
—
042349458
TRICARE
—
01
—
076259
BLUE CROSS BLUE SHEILD
MA
05
—
1715585
—
MA
01
—
590012303
RR MEDICARE
—
01
—
807136
TUFTS HEALTH PLAN
—
01
—
MH1050
HARVARD PILGRIM
—
Enumeration date
10/05/2005
Last updated
02/28/2013
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