Organization
SOUTHERN OSWEGO VOLUNTEER AMBULANCE CORPS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MONTGOMERY JR. (EXECUTIVE DIRECTOR)
(315) 676-5071
Entity
Organization
Contact information
Practice address
8 GERTRUDE DR, CENTRAL SQUARE, NY 13036-2600
(315) 676-5071
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
10751
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01668446
—
NY
01
—
147439FY
PREFERRED CARE
—
01
—
590009245
PALMETTO GBA RR MEDICARE
—
01
—
990578
MVP
—
Enumeration date
06/13/2006
Last updated
12/12/2011
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