Healthcare Provider Details

I. General information

NPI: 1295943298
Provider Name (Legal Business Name): FRANKLIN TOWNSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1571 DELSEA DR
FRANKLINVILLE NJ
08322-2391
US

IV. Provider business mailing address

PO BOX 1016
VOORHEES NJ
08043-7016
US

V. Phone/Fax

Practice location:
  • Phone: 856-694-1234
  • Fax:
Mailing address:
  • Phone: 856-784-3715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberFRN10310
License Number StateNJ

VIII. Authorized Official

Name: JUDSON MOORE
Title or Position: CFO
Credential:
Phone: 856-694-1234