Provider Demographics
NPI:1366135675
Name:WILLIAMS, RONALD COLLINS
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:COLLINS
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5419 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:PENNSAUKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08109-1742
Mailing Address - Country:US
Mailing Address - Phone:856-397-0947
Mailing Address - Fax:
Practice Address - Street 1:5419 PLYMOUTH AVE
Practice Address - Street 2:
Practice Address - City:PENNSAUKEN
Practice Address - State:NJ
Practice Address - Zip Code:08109-1742
Practice Address - Country:US
Practice Address - Phone:856-397-0947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
87-2712585OtherTRANSPORT COMPANY