| Organization Name: | LAKESHORE VOLUNTEER AMBULANCE INC |
| NPI Number: | 1083604540 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GEORGE LOCKWOOD (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 5841 New Hartford St Wolcott |
| State: | NY US |
| Postal Code: | 145901136 |
| Phone Number: | 3157546489 |
| Fax Number: | 3157548453 |
| NPI Enumeration Date: | 10/26/2005 |
| NPI Last Update Date: | 06/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3416L0300X |
| License Number: | 1069 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Transportation Services |
| Taxonomy Classification: | Ambulance |
| Taxonomy Specialization: | Land Transport |
| Taxonomy Definition: | |