MEDICARE: BEVERLY EMERGENCY SQUAD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	341600000X	Ambulance	B0311012	NJ

General Provider Information

NPI Number	:	1427214915
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEVERLY EMERGENCY SQUAD INC

Provider Business Mailing Address
First Line	:	703 MELBOURNE AVE
Second Line	:
City	:	BEVERLY
State	:	NJ
Zip	:	08010
Country	:	US
Telephone Number	:	609-386-7304
Fax Number	:

Provider Business Practice Location Address
First Line	:	703 MELBOURNE AVE
Second Line	:
City	:	BEVERLY
State	:	NJ
Zip	:	08010
Country	:	US
Telephone Number	:	609-386-7304
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANDREW S BALDINGER
Credential	:
Telephone Number	:	609-386-7304

Provider Enumeration Date	:	08/04/2008
Last Update Date	:	08/04/2008

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Directions to “BEVERLY EMERGENCY SQUAD INC ” Practice Location

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