Healthcare Provider Details

I. General information

NPI: 1356558910
Provider Name (Legal Business Name): HADDONFIELD AMBULANCE ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 12/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 N HADDON AVE
HADDONFIELD NJ
08033-2409
US

IV. Provider business mailing address

PO BOX 1016
VOORHEES NJ
08043-7016
US

V. Phone/Fax

Practice location:
  • Phone: 856-429-4308
  • Fax:
Mailing address:
  • Phone: 856-784-3715
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberHDNF04001
License Number StateNJ

VIII. Authorized Official

Name: KEVIN MACDONALD
Title or Position: CHAIRMAN
Credential:
Phone: 856-429-4308