Provider Demographics
NPI:1194720300
Name:TOWN OF COLONIE EMS
Entity type:Organization
Organization Name:TOWN OF COLONIE EMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:LEEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BIANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-783-2817
Mailing Address - Street 1:534 NEW LOUDON RD
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-5316
Mailing Address - Country:US
Mailing Address - Phone:518-783-2817
Mailing Address - Fax:518-783-2877
Practice Address - Street 1:534 NEW LOUDON RD
Practice Address - Street 2:
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-5316
Practice Address - Country:US
Practice Address - Phone:518-783-2817
Practice Address - Fax:518-783-2877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-15
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY03C0002341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY52156BMedicare ID - Type UnspecifiedPROVIDER NUMBER