=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912255126
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OAKHURST EMS INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/17/2012
-----------------------------------------------------
Last Update Date | 08/17/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 72 LARKIN PL
-----------------------------------------------------
City | OAKHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07755-1255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-244-2323
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 72 LARKIN PL
-----------------------------------------------------
City | OAKHURST
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07755-1255
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATIVE DIRECTOR
-----------------------------------------------------
Name | MR. DAVID HIERS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 732-244-2323
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 341600000X
-----------------------------------------------------
Taxonomy Name | Ambulance
-----------------------------------------------------
License Number | OAKHURST EMS
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------