MEDICARE: NATIONWIDE AMBULANCE SERVICES 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	3416L0300X	Land Ambulance		NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770581977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NATIONWIDE AMBULANCE SERVICES INC

Provider Business Mailing Address
First Line	:	409 NORTH AVE E
Second Line	:
City	:	CRANFORD
State	:	NJ
Zip	:	07016-2436
Country	:	US
Telephone Number	:	908-276-1199
Fax Number	:	908-276-3965

Provider Business Practice Location Address
First Line	:	409 NORTH AVE E
Second Line	:
City	:	CRANFORD
State	:	NJ
Zip	:	07016-2436
Country	:	US
Telephone Number	:	908-276-1199
Fax Number	:	908-276-3965

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ALEX IVCHENKO
Credential	:
Telephone Number	:	908-276-1199

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/21/2022

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