Healthcare Provider Details

I. General information

NPI: 1083820435
Provider Name (Legal Business Name): BOROUGH OF COLLINGSWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 W COLLINGS AVE
COLLINGSWOOD NJ
08108-3729
US

IV. Provider business mailing address

PO BOX 1016
VOORHEES NJ
08043-7016
US

V. Phone/Fax

Practice location:
  • Phone: 856-854-1043
  • Fax:
Mailing address:
  • Phone: 856-784-3715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberCOLL00137
License Number StateNJ

VIII. Authorized Official

Name: JOHN AMET
Title or Position: CHIEF
Credential:
Phone: 856-854-1043