Healthcare Provider Details

I. General information

NPI: 1487690921
Provider Name (Legal Business Name): GLASSBORO EMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

575 WOODBURY GLASSBORO RD
SEWELL NJ
08080-4563
US

IV. Provider business mailing address

1 S MAIN ST
GLASSBORO NJ
08028-2539
US

V. Phone/Fax

Practice location:
  • Phone: 856-256-0656
  • Fax:
Mailing address:
  • Phone: 856-256-0656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: SARAH LOVE
Title or Position: BILLING MANAGER
Credential:
Phone: 856-256-1390