Provider Demographics
NPI:1427054345
Name:LOWER TOWNSHIP RESCUE SQUAD
Entity type:Organization
Organization Name:LOWER TOWNSHIP RESCUE SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-886-2552
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:VILLAS
Mailing Address - State:NJ
Mailing Address - Zip Code:08251-0089
Mailing Address - Country:US
Mailing Address - Phone:609-886-2552
Mailing Address - Fax:609-886-9251
Practice Address - Street 1:101 GEORGIA AND MAIN ST
Practice Address - Street 2:
Practice Address - City:VILLAS
Practice Address - State:NJ
Practice Address - Zip Code:08251
Practice Address - Country:US
Practice Address - Phone:609-886-2552
Practice Address - Fax:609-886-9251
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-24
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3416L0300X, 343800000X, 343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3579000Medicaid
NJ3579000Medicaid