Provider Demographics
NPI:1972552958
Name:BOROUGH OF AUDUBON
Entity type:Organization
Organization Name:BOROUGH OF AUDUBON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:609-820-1614
Mailing Address - Street 1:606 W NICHOLSON RD
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:NJ
Mailing Address - Zip Code:08106-1930
Mailing Address - Country:US
Mailing Address - Phone:609-820-1614
Mailing Address - Fax:856-547-8222
Practice Address - Street 1:606 W NICHOLSON RD
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:NJ
Practice Address - Zip Code:08106-1930
Practice Address - Country:US
Practice Address - Phone:609-820-1614
Practice Address - Fax:856-547-8222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJAUD040693416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport