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General NPI Number Information
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NPI Number | 1942655576
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Entity Type | Organization
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Legal Business Name | ICARE AMBULANCE CORP
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 05/02/2016
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Provider Practice Location Address
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Address Line | 490 RIVERVIEW DR SUITE 9
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City | TOTOWA
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State | NJ
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Zip | 07512-2340
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Country | US
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Telephone | 347-415-1243
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Fax | 732-283-4020
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Provider Business Mailing Address
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Address Line | 490 RIVERVIEW DR SUITE 9
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City | TOTOWA
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State | NJ
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Zip | 07512-2340
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Country | US
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Telephone | 347-415-1243
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Fax | 732-283-4020
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Authorized Official
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Title or Position | OWNER
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Name | ISMAEL AWAWDEH
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Credential |
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Telephone | 347-415-1243
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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 | 102804
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License Number State | NJ
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