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General NPI Number Information
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NPI Number | 1366842353
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Entity Type | Organization
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Legal Business Name | J & K AMBULANCE LLC
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Dates
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Enumeration Date | 08/27/2014
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Last Update Date | 08/27/2014
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Provider Practice Location Address
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Address Line | 27 ARMOUR PL
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City | BERGENFIELD
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State | NJ
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Zip | 07621-1204
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Country | US
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Telephone | 201-384-3415
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Fax | 201-384-3417
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Provider Business Mailing Address
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Address Line | 27 ARMOUR PL
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City | BERGENFIELD
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State | NJ
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Zip | 07621-1204
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Country | US
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Telephone | 201-384-3415
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Fax | 201-384-3417
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARINO R FUGABAN
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Credential |
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Telephone | 201-384-3415
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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 | 100702
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License Number State | NJ
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