Organization
BLACK RIVER AMBULANCE SQUAD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN CLAUDE GAINES (BILLING OFFICER)
(315) 773-4501
Entity
Organization
Contact information
Practice address
121 LERAY ST, BLACK RIVER, NY 13612-2114
(315) 773-4501
(315) 775-0291
Mailing address
121 LERAY ST, PO BOX 314, BLACK RIVER, NY 13612-2114
(315) 773-4501
(315) 775-0291
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
2232
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01793580
—
NY
Enumeration date
07/30/2007
Last updated
07/30/2007
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