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General NPI Number Information
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NPI Number | 1477853661
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Entity Type | Organization
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Legal Business Name | VALOR AMBULANCE SERVICE LLC
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 10/22/2010
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Provider Practice Location Address
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Address Line | 175 EDGAR ST
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2114
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Country | US
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Telephone | 732-602-8291
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Fax |
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Provider Business Mailing Address
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Address Line | 175 EDGAR ST
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2114
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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 | PRESIDENT
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Name | PETER REBOVICH
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Credential |
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Telephone | 732-602-8291
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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 | V1212067
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License Number State | NJ
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