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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
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