=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194931584
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY OF MARGATE CITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 04/05/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 S WASHINGTON AVE
-----------------------------------------------------
City | MARGATE CITY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08402-2301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-822-6712
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9001 WINCHESTER AVE
-----------------------------------------------------
City | MARGATE CITY
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08402-1239
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-822-4088
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | MRS. LISA MCLAUGHLIN
-----------------------------------------------------
Credential | CPA, CMFO
-----------------------------------------------------
Telephone | 609-822-4088
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number | MARG00336
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------