Basic Information
| Provider Information | |||||||||
| NPI: | 1346277209 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WCA SERVICES CORPORATION | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | |||||||||
| OtherOrganizationName: | ALSTAR EMS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
| OtherFirstName: | |||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | |||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 41 | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147020041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166647353 | ||||||||
| FaxNumber: | 7164872488 | ||||||||
| Practice Location | |||||||||
| Address1: | 335 E 3RD ST | ||||||||
| Address2: | |||||||||
| City: | JAMESTOWN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 147015554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166647353 | ||||||||
| FaxNumber: | 7164872488 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2006 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | |||||||||
| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 7166647353 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 341600000X | 0628 | NY | N | Transportation Services | Ambulance | 3416L0300X | 0654 | NY | N | Transportation Services | Ambulance | Land Transport | 3416L0300X | 0628 | NY | N | Transportation Services | Ambulance | Land Transport | 343900000X | 2300 | NY | N | Transportation Services | Non-emergency Medical Transport (VAN) | 347B00000X | 2300 | NY | N | Transportation Services | Bus | 341600000X | 0654 | NY | Y | Transportation Services | Ambulance |
ID Information
| ID | Type | State | Issuer | Description | 005860091 | 01 | BLUE CROSS | OTHER | 590002866 | 01 | RAILROAD MEDICARE | OTHER | 00011327401 | 01 | NY | UNIVERA | OTHER | 01049412 | 05 | NY | MEDICAID | 8190292 | 01 | NY | INDEPENDENT HEALTH | OTHER |