Provider Demographics
NPI:1003147794
Name:HOPATCONG AMBULANCE SERVICE INC
Entity Type:Organization
Organization Name:HOPATCONG AMBULANCE SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSOMANNO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-770-0440
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:856-784-3715
Mailing Address - Fax:856-768-2739
Practice Address - Street 1:516 RIVER STYX RD
Practice Address - Street 2:
Practice Address - City:HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07843-1827
Practice Address - Country:US
Practice Address - Phone:973-770-0440
Practice Address - Fax:973-810-5589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJH19110103416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport