=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811606395
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BOROUGH OF HADDONFIELD
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/23/2022
-----------------------------------------------------
Last Update Date | 08/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15 N HADDON AVE
-----------------------------------------------------
City | HADDONFIELD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08033-2456
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 856-429-4308
-----------------------------------------------------
Fax | 336-791-0196
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 547
-----------------------------------------------------
City | WHEELING
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60090-0547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 743-264-2420
-----------------------------------------------------
Fax | 336-791-0196
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | SHARON MCCULLOUGH
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 856-429-4700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3416L0300X
-----------------------------------------------------
Taxonomy Name | Land Ambulance
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------