Healthcare Provider Details

I. General information

NPI: 1871691774
Provider Name (Legal Business Name): AMERICAN LEGION AMBULANCE ASSOC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 06/13/2024
Certification Date: 06/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 BROAD ST
ELMER NJ
08318-2200
US

IV. Provider business mailing address

20 E TAUNTON RD STE 500
BERLIN NJ
08009-2615
US

V. Phone/Fax

Practice location:
  • Phone: 856-769-1779
  • Fax:
Mailing address:
  • Phone: 866-476-1702
  • Fax: 609-481-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: RANSOM WILLARD
Title or Position: PRESIDENT
Credential:
Phone: 856-460-1905