Healthcare Provider Details

I. General information

NPI: 1982911897
Provider Name (Legal Business Name): SOUTH JERSEY MEDICAL TRANSPORTATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 FRONT ST
SALEM NJ
08079-1048
US

IV. Provider business mailing address

28 FRONT ST
SALEM NJ
08079-1048
US

V. Phone/Fax

Practice location:
  • Phone: 856-759-4269
  • Fax: 856-759-4753
Mailing address:
  • Phone: 856-759-4269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: ADRIAN C BURHUI
Title or Position: ADMINISTRATOR
Credential:
Phone: 856-759-4269