Healthcare Provider Details

I. General information

NPI: 1386805232
Provider Name (Legal Business Name): BLACK KNIGHT MEDICAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 06/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 PEARL ST
CAMDEN NJ
08102-1033
US

IV. Provider business mailing address

901 PEARL ST
CAMDEN NJ
08102-1033
US

V. Phone/Fax

Practice location:
  • Phone: 856-308-5283
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNJ

VIII. Authorized Official

Name: THOMAS E CURTIS
Title or Position: CEO/PRESIDENT
Credential:
Phone: 856-308-5283