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General NPI Number Information
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NPI Number | 1063693919
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Entity Type | Organization
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Legal Business Name | GEM AMBULANCE LLC
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 07/01/2015
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Provider Practice Location Address
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Address Line | 1750 CEDAR BRIDGE AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-6921
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Country | US
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Telephone | 732-575-1700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5
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City | LAKEWOOD
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State | NJ
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Zip | 08701-0005
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Country | US
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Telephone | 732-575-1700
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACOB HALPERN
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Credential |
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Telephone | 732-575-1700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | G1512050
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License Number State | NJ
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