Healthcare Provider Details

I. General information

NPI: 1770777674
Provider Name (Legal Business Name): COUNTY OF GLOUCESTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 12/11/2007
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

575 WOODBURY GLASSBORO RD
SEWELL NJ
08080-4563
US

V. Phone/Fax

Practice location:
  • Phone: 856-256-1389
  • Fax: 856-256-0656
Mailing address:
  • Phone: 856-256-1389
  • Fax: 856-256-0656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. SARAH D LOVE
Title or Position: EMERGIMED BILLING SERVICES/OWNER
Credential:
Phone: 856-256-1389