Organization
CLYDE FIRE DEPT AMB SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEATHER M LIZOTTE (AUTHORIZED AGENT)
(800) 452-8191
Entity
Organization
Contact information
Practice address
15 FORD ST, CLYDE, NY 14433-1306
(315) 923-7667
(315) 923-7419
Mailing address
PO BOX 290184, WETHERSFIELD, CT 06129-0184
(800) 452-8191
(860) 721-6362
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
5814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01981277
—
NY
Enumeration date
10/11/2005
Last updated
08/22/2020
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