MEDICARE: BOROUGH OF WILDWOOD CREST

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	3416L0300X	NJ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	P00007707	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	91000989200	OTHER	AMERICHOICE OF NJ
2	30020586	OTHER	KEYSTONE MERCY HEALTH PLA
3	3181877	OTHER	AETNA HMO
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	2159308000	OTHER	AMERIHEALTH HMO NJ DE
7	1172598	OTHER	HORIZON NJ HEALTH
8	A28787660	OTHER	OXFORD HEALTH PLANS

General Provider Information

NPI Number	:	1922013366
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOROUGH OF WILDWOOD CREST

Provider Business Mailing Address
First Line	:	6101 PACIFIC AVE
Second Line	:
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-4113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 PACIFIC AVE
Second Line	:
City	:	WILDWOOD CREST
State	:	NJ
Zip	:	08260-4113
Country	:	US
Telephone Number	:	609-522-5176
Fax Number	:

Authorized Official
Title or Position	:	BOROUGH CLERK
Name	:	KEVIN YECCO
Credential	:
Telephone Number	:	609-522-5176

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	08/22/2020

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Directions to “BOROUGH OF WILDWOOD CREST ” Practice Location

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