Organization
GRAHAMSVILLE FIRST AID SQUAD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN LYNN MAHNKEN (CAPTAIN)
(845) 985-2839
Entity
Organization
Contact information
Practice address
499 MAIN ST, GRAHAMSVILLE, NY 12740
(914) 985-2331
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
09767
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01671521
—
NY
01
—
27870
GHI
—
01
—
590012121
PALMETTO GBA RR MEDICARE
—
Enumeration date
01/24/2006
Last updated
04/11/2023
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