Provider Demographics
NPI:1588706949
Name:GENERAL AMBULETTE SERVICE INC
Entity type:Organization
Organization Name:GENERAL AMBULETTE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRENT
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINTRAUB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-563-5366
Mailing Address - Street 1:253 E 204TH ST
Mailing Address - Street 2:203
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10458-1301
Mailing Address - Country:US
Mailing Address - Phone:718-933-5373
Mailing Address - Fax:718-561-2525
Practice Address - Street 1:253 E 204TH ST
Practice Address - Street 2:203
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-1301
Practice Address - Country:US
Practice Address - Phone:718-933-5373
Practice Address - Fax:718-561-2525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01037594Medicaid