Organization
INDIAN LAKE VOLUNTEER AMBULANCE CORP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JOSHUA B WELLS EMT-CC (OPERATIONS MANAGER)
(518) 796-0507
Entity
Organization
Contact information
Practice address
105 PELON ROAD, INDIAN LAKE, NY 12842-0117
(518) 648-0095
(518) 648-0095
Mailing address
6231 NYS RT 30, INDIAN LAKE, NY 12842-0039
(518) 648-0095
(518) 648-0095
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
12170
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03433790
—
NY
Enumeration date
06/22/2011
Last updated
10/28/2018
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