Organization
TOWN OF TULLY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD WAKULA (CAPTAIN)
(315) 696-6414
Entity
Organization
Contact information
Practice address
1 RAILROAD ST, TULLY, NY 13159-3245
(315) 696-6414
(315) 696-8396
Mailing address
PO BOX 535, BALDWINSVILLE, NY 13027-0535
(315) 635-1789
(315) 635-3289
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
10383
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01943255
—
NY
01
—
350751
MVP
—
01
—
959978
GHI
—
Enumeration date
06/13/2006
Last updated
07/30/2024
Update your record
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