Organization
FORT ANN RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN T. NEUMANN (PRESIDENT)
(518) 639-1005
Entity
Organization
Contact information
Practice address
11287 STATE ROUTE 149, FORT ANN, NY 12827
(518) 639-1005
Mailing address
8610 MAIN STREET, WILLIAMSVILLE, NY 14221-7455
(716) 204-3350
(716) 247-5274
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
10258
NY
3416L0300X
Land Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01767817
—
NY
01
—
10025830
CDPHP
—
01
—
590011141
PALMETTO GBA RAILROAD
—
01
—
958231
MVP
—
Enumeration date
11/23/2005
Last updated
12/04/2020
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