Provider Demographics
NPI:1366122616
Name:MONTGOMERY COUNTY
Entity type:Organization
Organization Name:MONTGOMERY COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SARGENT
Authorized Official - Prefix:
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-853-5500
Mailing Address - Street 1:PO BOX 787
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-0787
Mailing Address - Country:US
Mailing Address - Phone:888-603-2455
Mailing Address - Fax:
Practice Address - Street 1:200 CLARK DR
Practice Address - Street 2:
Practice Address - City:FULTONVILLE
Practice Address - State:NY
Practice Address - Zip Code:12072
Practice Address - Country:US
Practice Address - Phone:518-853-5500
Practice Address - Fax:518-853-4096
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTGOMERY COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance