Healthcare Provider Details

I. General information

NPI: 1356661805
Provider Name (Legal Business Name): THE LUMBERTON EMERGENCY SQUAD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2010
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MUNICIPAL DR
LUMBERTON NJ
08048-4556
US

IV. Provider business mailing address

PO BOX 18533
PITTSBURGH PA
15236-0533
US

V. Phone/Fax

Practice location:
  • Phone: 609-261-1828
  • Fax:
Mailing address:
  • Phone: 800-240-6365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberL311021
License Number StateNJ

VIII. Authorized Official

Name: JAMIE WOOD
Title or Position: CHIEF
Credential:
Phone: 609-261-1828