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General NPI Number Information
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NPI Number | 1912416363
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Entity Type | Organization
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Legal Business Name | GOLD BEAR SHUTTLE
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Dates
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Enumeration Date | 09/28/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 300 MILL STREET
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City | MOORESTOWN
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State | NJ
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Zip | 08057
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Country | US
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Telephone | 856-234-7577
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Fax |
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Provider Business Mailing Address
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Address Line | 300 MILL ST
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City | MOORESTOWN
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State | NJ
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Zip | 08057-2522
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Country | US
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Telephone | 856-234-7577
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JUSTINE ZEROSKI
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Credential |
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Telephone | 609-351-1587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 347B00000X
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Taxonomy Name | Bus
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License Number |
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License Number State |
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