Healthcare Provider Details

I. General information

NPI: 1811977432
Provider Name (Legal Business Name): BELLEPLAIN EMERGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 04/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

138 WASHINGTON ST
BELLEPLAIN NJ
08270-4001
US

IV. Provider business mailing address

167 BROAD ST
BELLEPLAIN NJ
08270-4001
US

V. Phone/Fax

Practice location:
  • Phone: 609-861-5250
  • Fax: 609-861-2288
Mailing address:
  • Phone: 609-861-5250
  • Fax: 609-861-2288

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier6507506
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: MR. WILLIAM H KING SR.
Title or Position: ADMINISTRATOR
Credential:
Phone: 609-861-5250