=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578407193
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAITH MEDICAL SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/15/2026
-----------------------------------------------------
Last Update Date | 04/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 256 BERGEN BLVD STE 101
-----------------------------------------------------
City | WOODLAND PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07424-2502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 862-888-2328
-----------------------------------------------------
Fax | 973-304-4388
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 256 BERGEN BLVD STE 101
-----------------------------------------------------
City | WOODLAND PARK
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07424-2502
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax | 973-304-4388
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HEROLD J NELSON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 862-888-2328
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------