Healthcare Provider Details

I. General information

NPI: 1023097268
Provider Name (Legal Business Name): WHITEHOUSE FIRST AID & RESCUE SQUAD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2006
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 MAIN ST
WHITEHOUSE STATION NJ
08889-3620
US

IV. Provider business mailing address

PO BOX 175
WHITEHOUSE STATION NJ
08889-0175
US

V. Phone/Fax

Practice location:
  • Phone: 908-534-2509
  • Fax: 908-534-2585
Mailing address:
  • Phone: 908-534-2509
  • Fax: 908-534-2585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberWHITE028
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code341600000X
TaxonomyAmbulance
License NumberWHITE028
License Number StateNJ

VIII. Authorized Official

Name: ROBERT J RAINEY
Title or Position: PRESIDENT
Credential:
Phone: 908-534-2509