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Organization

BOULEVARD VAN CITY LLC

Active
Parent organization
BOULEVARD VAN CITY LLC
Other names
Boulevard Van City & Home Mobility
Organization subpart
Yes

Provider details

NPI number
Legal business name
BOULEVARD VAN CITY LLC
Authorized official
MR. FRANK J SOUTHERLAND (OWNER)
(716) 731-4335
Entity
Organization

Contact information

Practice address
2708 NIAGARA FALLS BLVD, NIAGARA FALLS, NY 14304-4517
(716) 731-4335
(716) 731-4331
Mailing address
2708 NIAGARA FALLS BLVD, NIAGARA FALLS, NY 14304-4517
(716) 731-4335
(716) 731-4331

Taxonomy

Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
171WV0202X
Vehicle Modifications Contractor
Primary
343900000X
Non-emergency Medical Transport (VAN)
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04082239
NY
Enumeration date
02/03/2017
Last updated
01/08/2020
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