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General NPI Number Information
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NPI Number | 1538374186
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Entity Type | Organization
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Legal Business Name | MAGNOLIA AMBULANCE CORPS INC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 112 S WARWICK RD
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City | MAGNOLIA
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State | NJ
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Zip | 08049-1338
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Country | US
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Telephone | 856-784-8089
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Fax | 856-784-1218
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Provider Business Mailing Address
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Address Line | 112 S WARWICK RD
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City | MAGNOLIA
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State | NJ
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Zip | 08049-1338
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Country | US
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Telephone | 856-784-8089
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Fax | 856-784-1218
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. NICK D'AMICO
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Credential |
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Telephone | 856-784-8089
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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 | MAGN00334
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License Number State | NJ
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