1225028707 NPI number — ATLANTIC AMBULANCE CORP.

Table of content: (NPI 1225028707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225028707 NPI number — ATLANTIC AMBULANCE CORP.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTIC AMBULANCE CORP.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225028707
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
475 SOUTH STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MORRISTOWN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07960-6459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:
973-360-0542

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 DORSA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVINGSTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07039-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-535-8500
Provider Business Practice Location Address Fax Number:
973-535-8340
Provider Enumeration Date:
10/25/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LENAHAN
Authorized Official First Name:
KEVIN
Authorized Official Middle Name:
Authorized Official Title or Position:
VP CFO
Authorized Official Telephone Number:
973-660-3190

Provider Taxonomy Codes

  • Taxonomy code: 341600000X , with the licence number:  ATLHLTH01 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0054968 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 590015317 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com