Organization
FIVE COUNTIES AMBULANCE SERVICE INC
Active
Other names
American Medical Response
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD VAN HORNE (PRESIDENT)
(303) 495-1220
Entity
Organization
Contact information
Practice address
1160 LINCOLN AVE, HOLBROOK, NY 11741-2245
(613) 218-4070
(613) 218-4087
Mailing address
PO BOX 100296, ATLANTA, GA 30384-0296
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01864048
—
NY
01
—
1000023985
NY WORKERS COMP
NY
Enumeration date
05/12/2006
Last updated
09/13/2013
Update your record
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