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General NPI Number Information
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NPI Number | 1194155200
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Entity Type | Organization
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Legal Business Name | MEDLINE HEALTH GROUP LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 11/26/2013
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Last Update Date | 12/04/2013
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Provider Practice Location Address
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Address Line | 984 US HIGHWAY 9
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City | PARLIN
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State | NJ
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Zip | 08859-2033
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Country | US
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Telephone | 646-283-6896
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Fax |
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Provider Business Mailing Address
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Address Line | 984 US HIGHWAY 9
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City | PARLIN
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State | NJ
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Zip | 08859-2033
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | PLAMEN MIHOV
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Credential |
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Telephone | 646-283-6896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 100587
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License Number State | NJ
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