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General NPI Number Information
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NPI Number | 1619363975
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Entity Type | Organization
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Legal Business Name | EAST BRUNSWICK RESCUE SQUAD
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Dates
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Enumeration Date | 04/13/2015
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Last Update Date | 04/13/2015
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Provider Practice Location Address
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Address Line | 346 CRANBURY RD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-3062
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Country | US
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Telephone | 732-238-8739
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 949
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City | MATAWAN
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State | NJ
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Zip | 07747-0949
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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 | MR. MATTHEW PHILLIPS
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Credential |
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Telephone | 732-620-3167
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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 |
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License Number State | NJ
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