Healthcare Provider Details

I. General information

NPI: 1659506541
Provider Name (Legal Business Name): BLOOMSBURY RESCUE SQUAD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88 MAIN ST
BLOOMSBURY NJ
08804-3068
US

IV. Provider business mailing address

88 MAIN STREET
BLOOMSBURY NJ
08804-0022
US

V. Phone/Fax

Practice location:
  • Phone: 908-479-6221
  • Fax: 908-479-1950
Mailing address:
  • Phone: 908-479-6221
  • Fax: 908-479-1950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBRA G SOLOMON
Title or Position: TREASURER
Credential:
Phone: 908-479-6072