Organization
ONTARIO COUNTY ADVANCED LIFE SUPPORT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REGINALD ALLEN (CHIEF)
(585) 396-6672
Entity
Organization
Contact information
Practice address
233 N PEARL ST, CANANDAIGUA, NY 14424-1439
(585) 396-6672
(585) 396-0154
Mailing address
350 PARRISH ST, CANANDAIGUA, NY 14424-1731
(585) 396-6672
(585) 396-0154
Taxonomy
Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
3496
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01895192
—
NY
01
—
104405FY
PREFERRED CARE #
NY
01
—
P0100637AL
BLUE CHOICE
NY
Enumeration date
01/17/2007
Last updated
08/22/2020
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