Organization
WATERFORD RESCUE SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY ANN WEIR (COO)
(518) 237-2473
Entity
Organization
Contact information
Practice address
46 4TH ST, WATERFORD, NY 12188-2327
(518) 237-2473
(518) 235-0084
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
10789
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01470364
—
NY
01
—
10019558
CDPHP
—
01
—
590008498
PALMETTO GBA RR MEDICARE
—
01
—
9602402
GHI
—
Enumeration date
07/23/2006
Last updated
09/17/2020
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