Organization
ELIZABETHTOWN-LEWIS EMERGENCY SQUAD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA BASHAW (PRESIDENT)
(518) 873-2122
Entity
Organization
Contact information
Practice address
8143 US RT 9, LEWIS, NY 12950
(518) 873-2122
(518) 873-3784
Mailing address
107 WASHINGTON AVE, ALBANY, NY 12210-2269
(888) 603-2455
(888) 603-2455
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
11409
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03134232
—
NY
01
—
P00772385
MEDICARE RAILROAD
—
Enumeration date
02/19/2009
Last updated
01/03/2015
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