Provider Demographics
NPI:1730179128
Name:LANCASTER VOLUNTEER AMBULANCE CORPS, INC.
Entity type:Organization
Organization Name:LANCASTER VOLUNTEER AMBULANCE CORPS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:POPOILKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-341-5372
Mailing Address - Street 1:8610 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7455
Mailing Address - Country:US
Mailing Address - Phone:716-204-3350
Mailing Address - Fax:716-247-5274
Practice Address - Street 1:40 EMBRY PLACE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-1703
Practice Address - Country:US
Practice Address - Phone:716-683-3282
Practice Address - Fax:716-683-5466
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14843416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
1730179128OtherMEDICARE
590007543OtherRAILROAD MEDICARE
NY01377522Medicaid