Provider Demographics
NPI:1548815087
Name:ADIRONDACK CARE TRANSPORTATION INC
Entity type:Organization
Organization Name:ADIRONDACK CARE TRANSPORTATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAJJAD
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-480-9646
Mailing Address - Street 1:979 BIRCHWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-3117
Mailing Address - Country:US
Mailing Address - Phone:518-747-2569
Mailing Address - Fax:
Practice Address - Street 1:979 BIRCHWOOD LN
Practice Address - Street 2:
Practice Address - City:NISKAYUNA
Practice Address - State:NY
Practice Address - Zip Code:12309-3117
Practice Address - Country:US
Practice Address - Phone:518-747-2569
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03999373Medicaid