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General NPI Number Information
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NPI Number | 1609822246
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Entity Type | Organization
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Legal Business Name | MILLVILLE RESCUE SQUAD
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 12/08/2009
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Provider Practice Location Address
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Address Line | 600 CEDAR ST
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City | MILLVILLE
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State | NJ
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Zip | 08332-9415
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Country | US
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Telephone | 856-825-5063
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Fax | 856-825-4713
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Provider Business Mailing Address
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Address Line | PO BOX 576
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City | MILLVILLE
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State | NJ
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Zip | 08332-0576
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Country | US
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Telephone | 856-825-5063
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Fax | 856-825-4713
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MR. JOHN REDDEN
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Credential |
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Telephone | 856-825-5063
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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 | MILL00381
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License Number State | NJ
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