=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447730619
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREAT MEADOWS EMERGENCY MEDICAL SERVICE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2018
-----------------------------------------------------
Last Update Date | 11/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3 REGINA LN
-----------------------------------------------------
City | GREAT MEADOWS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07838
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-637-4477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 18537
-----------------------------------------------------
City | PLEASANT HILLS
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 15236-0537
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-240-6365
-----------------------------------------------------
Fax | 724-615-1448
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | TREASURER
-----------------------------------------------------
Name | SAMANTHA VAZQUEZ NICHOLLS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 908-627-4477
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------