MEDICARE: AIR AMBULANCE BY MED-X

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	347E00000X	Transportation Broker

General Provider Information

NPI Number	:	1538486238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AIR AMBULANCE BY MED-X

Provider Business Mailing Address
First Line	:	PO BOX 720
Second Line	:
City	:	MATAWAN
State	:	NJ
Zip	:	07747-0720
Country	:	US
Telephone Number	:	732-721-2828
Fax Number	:	732-721-2860

Provider Business Practice Location Address
First Line	:	540 BORDENTOWN AVE
Second Line	:	STE 4550
City	:	SOUTH AMBOY
State	:	NJ
Zip	:	08879-1546
Country	:	US
Telephone Number	:	732-721-2828
Fax Number	:	732-721-2860

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	LEONARD G AUGUST
Credential	:
Telephone Number	:	732-721-2828

Provider Enumeration Date	:	04/21/2010
Last Update Date	:	04/21/2010

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