1922279249 NPI number — ASSIGN MEDICAL TRANSPORT

Table of content: (NPI 1922279249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922279249 NPI number — ASSIGN MEDICAL TRANSPORT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSIGN MEDICAL TRANSPORT
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:
6
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:
1922279249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
299 W FORT LEE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOGOTA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07603-1288
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-996-0029
Provider Business Mailing Address Fax Number:
201-996-0466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
299 W FORT LEE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOGOTA
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07603-1288
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-996-0029
Provider Business Practice Location Address Fax Number:
201-996-0466
Provider Enumeration Date:
03/13/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
IRISH
Authorized Official First Name:
BERTSFORD
Authorized Official Middle Name:
EDISON
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
201-996-0029

Provider Taxonomy Codes

  • Taxonomy code: 343900000X , with the licence number:  ASSI00062 , 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: 7320507 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".