Healthcare Provider Details

I. General information

NPI: 1932561420
Provider Name (Legal Business Name): TECH MEDICAL SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/23/2016
Last Update Date: 03/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 BELMONT AVE
BELLEVILLE NJ
07109-1102
US

IV. Provider business mailing address

212 BELMONT AVE
BELLEVILLE NJ
07109-1102
US

V. Phone/Fax

Practice location:
  • Phone: 973-518-8449
  • Fax: 201-537-8045
Mailing address:
  • Phone: 973-518-8449
  • Fax: 201-537-8045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number0712059
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number0712059
License Number StateNJ

VIII. Authorized Official

Name: MATTHEW S MCQUEEN
Title or Position: OWNER
Credential:
Phone: 973-518-8449