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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
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