Provider Demographics
NPI:1215261680
Name:OMNI MEDICAL TRANSPORT
Entity type:Organization
Organization Name:OMNI MEDICAL TRANSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEMARINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-704-1857
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:CEDAR BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08018-0152
Mailing Address - Country:US
Mailing Address - Phone:609-704-1857
Mailing Address - Fax:609-704-1859
Practice Address - Street 1:618 S WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1315
Practice Address - Country:US
Practice Address - Phone:609-704-1857
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-01
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport