1982603544 NPI number — RAHWAY FIRST AID EMERGENCY SQUAD

Table of content: (NPI 1982603544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982603544 NPI number — RAHWAY FIRST AID EMERGENCY SQUAD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAHWAY FIRST AID EMERGENCY SQUAD
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:
1982603544
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18105-0207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-664-2007
Provider Business Mailing Address Fax Number:
484-664-2015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
905 STONE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAHWAY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07065-2742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-815-0464
Provider Business Practice Location Address Fax Number:
732-956-2101
Provider Enumeration Date:
07/17/2005

Additional Information

Authorized Official

Authorized Official Last Name:
JANUIK
Authorized Official First Name:
TORY
Authorized Official Middle Name:
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
732-815-0464

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 112577 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1167513 . This is a "HORIZON HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 90020360001 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: A2724245 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 8989702 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3017724 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 910007918 00 . This is a "AMERICHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0X00J25601 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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