Provider Demographics
NPI:1316148406
Name:CITY OF BRIDGETON
Entity type:Organization
Organization Name:CITY OF BRIDGETON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-451-0091
Mailing Address - Street 1:PO BOX 1016
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-7016
Mailing Address - Country:US
Mailing Address - Phone:856-784-8004
Mailing Address - Fax:
Practice Address - Street 1:1 ORANGE ST
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:NJ
Practice Address - Zip Code:08302
Practice Address - Country:US
Practice Address - Phone:856-451-0090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJBRID000943416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0564453OtherAETNA
NJ0176392000OtherAMERIHEALTH
NJ1077652OtherHORIZON MERCY
NJ91000316901OtherAMERICHOICE
NJ7295405Medicaid
NJ0176392000OtherAMERIHEALTH