MEDICARE: NORTHFIELD RESCUE 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	3416L0300X	Land Ambulance

General Provider Information

NPI Number	:	1902078280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHFIELD RESCUE SQUAD INC.

Provider Business Mailing Address
First Line	:	PO BOX 221
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-0221
Country	:	US
Telephone Number	:	609-641-2832
Fax Number	:

Provider Business Practice Location Address
First Line	:	1600 SHORE RD
Second Line	:
City	:	NORTHFIELD
State	:	NJ
Zip	:	08225-2251
Country	:	US
Telephone Number	:	609-641-2832
Fax Number	:

Authorized Official
Title or Position	:	CHIEF
Name	:	MR. RAYMOND JAMES ADAMS
Credential	:
Telephone Number	:	609-641-2832

Provider Enumeration Date	:	03/27/2008
Last Update Date	:	05/29/2008

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