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General NPI Number Information
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NPI Number | 1528472594
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Entity Type | Organization
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Legal Business Name | SKYLINE AMBULANCE SERVICES
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Dates
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Enumeration Date | 06/17/2014
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Last Update Date | 07/06/2015
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Provider Practice Location Address
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Address Line | 81 2ND ST SUITE 3
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City | SOUTH ORANGE
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State | NJ
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Zip | 07079-1861
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Country | US
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Telephone | 973-619-6200
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Fax |
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Provider Business Mailing Address
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Address Line | 111 ELLERY AVE
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City | IRVINGTON
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State | NJ
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Zip | 07111-1518
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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 | OWNER
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Name | MR. DARRIUS WILLIAMS JR.
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Credential |
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Telephone | 973-934-3765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number |
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License Number State |
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