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BLACK RIVER AMBULANCE SQUAD, INC
NPI 1972793602
Ambulance - Land Transport in Black River, NY

Active since July 30, 2007CLIA 33D1102161 · Waiver
121 LERAY ST, BLACK RIVER, NY 13612(315) 773-4501(315) 775-0291 Get Directions Write a Review

NPPES record last updated: July 30, 2007. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Black River Ambulance Squad, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLACK RIVER AMBULANCE SQUAD, INC (NPI 1972793602) is a healthcare organization registered as a land transport in Black River, New York and active in the NPI registry since July 2007. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Alan Claude Gaines, Billing Officer, as its authorized official.

NPPES Registry Identity

NPI1972793602
Entity TypeOrganization
Primary Taxonomy3416L0300X
Legal Business NameBLACK RIVER AMBULANCE SQUAD, INC
Location Address121 LERAY STBlack River, NY 13612-2114
Mailing Address121 Leray St, Po Box 314Black River, NY 13612-2114 · (315) 773-4501 · Fax (315) 775-0291
Phone(315) 773-4501
Fax(315) 775-0291
Organization SubpartNo
Authorized OfficialAlan Claude GainesBilling Officer · (315) 773-4501
Enumeration DateJuly 30, 2007
✔ NPI 1972793602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulance · Land TransportTransportation Services
Taxonomy Code3416L0300X
License✔ Licensed in NY · 2232
121 LERAY ST, Black River, NY 13612
Open in Google Maps ↗

Other Identifiers 2

Medicaid01793580NY
Medicare PIN56644BNY

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 33D1102161

Black River Ambulance Squad Inc · Black River, NY
Active · expires Mar 26, 2027
CLIA Number33D1102161
Laboratory TypeAmbulance
Certificate Effective DateJuly 14, 2009
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Maja L. Lundborg-Gray
Laboratory Phone(315) 773-4501
Laboratory LocationBlack River Ambulance Squad Inc121 Leray Street, Black River, NY 13612
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Ground mileage, per statute mile A0425
Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.
290 services27 patients
Ambulance service, basic life support, emergency transport (bls-emergency) A0429
Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.
29 services25 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Black River Ambulance Squad, Inc's NPI number?

The NPI number for Black River Ambulance Squad, Inc is 1972793602. It was assigned to this organization in the NPPES registry on July 30, 2007.

Where is Black River Ambulance Squad, Inc located?

Black River Ambulance Squad, Inc is located at 121 Leray St, Black River, NY 13612. The listed phone number is (315) 773-4501.

What is Black River Ambulance Squad, Inc's specialty?

The primary specialty registered for this NPI is Ambulance, specializing in Land Transport, with taxonomy code 3416L0300X.

Does Black River Ambulance Squad, Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1102161) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Black River Ambulance Squad, Inc was last updated on July 30, 2007. NPI Profile syncs with the weekly NPPES data releases published by CMS.