Organization
JOHNSBURG EMERGENCY SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH CHARLES CONNELLY (PRESIDENT)
(518) 812-5282
Entity
Organization
Contact information
Practice address
624 PEACEFUL VALLEY ROAD, NORTH CREEK, NY 12853
(518) 251-2244
(518) 251-2257
Mailing address
624 PEACEFUL VALLEY ROAD, NORTH CREEK, NY 12853
(518) 251-2244
(518) 251-2257
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
09840
NY
341600000X
Ambulance
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000416627001
BS OF NORTHEASTERN NY
—
05
—
02572278
—
NY
01
—
BA0187
MEDICARE PTAN
NY
01
—
P00136074
PALMETTO GBA RAILROAD
—
Enumeration date
12/06/2005
Last updated
07/21/2022
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