Organization
TOWN OF LIBERTY VOLUNTEER AMBULANCE CORPS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY RAY COOPERSTEIN (EMS ADMINISTRATOR)
(845) 292-4320
Entity
Organization
Contact information
Practice address
178 MILL ST, LIBERTY, NY 12754
(845) 292-4320
Mailing address
PO BOX 535, BALDWINSVILLE, NY 13027
(315) 635-1789
(315) 635-3289
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
10311
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01643778
—
NY
01
—
955003
MVP
—
01
—
9599736
GHI
—
Enumeration date
07/03/2006
Last updated
08/22/2020
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