Healthcare Provider Details

I. General information

NPI: 1609855840
Provider Name (Legal Business Name): CITY OF VENTNOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 11/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 N NEW HAVEN AVE
VENTNOR NJ
08406-2130
US

IV. Provider business mailing address

PO BOX 1016
VOORHEES NJ
08043-7016
US

V. Phone/Fax

Practice location:
  • Phone: 609-823-7942
  • Fax: 609-823-7767
Mailing address:
  • Phone: 856-784-8004
  • Fax: 856-768-2739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberVENT00607
License Number StateNJ

VIII. Authorized Official

Name: BERT SABO
Title or Position: CHIEF
Credential:
Phone: 609-823-7942