Provider Demographics
NPI:1891989281
Name:STATEWWIDE AMBULETTE SER., INC.
Entity type:Organization
Organization Name:STATEWWIDE AMBULETTE SER., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HEBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-668-8750
Mailing Address - Street 1:557 N MACQUESTEN PKWY
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-2666
Mailing Address - Country:US
Mailing Address - Phone:914-668-8750
Mailing Address - Fax:914-668-5158
Practice Address - Street 1:557 N MACQUESTEN PKWY
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552-2666
Practice Address - Country:US
Practice Address - Phone:914-668-8750
Practice Address - Fax:914-668-5158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30441343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00916812Medicaid