Provider Demographics
NPI:1003941691
Name:ELMER AMBULANCE CORPS., INC.
Entity Type:Organization
Organization Name:ELMER AMBULANCE CORPS., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:1ST LEUIT.
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:RAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-358-6630
Mailing Address - Street 1:30 BROAD ST.
Mailing Address - Street 2:P.O. BOX 812
Mailing Address - City:ELMER
Mailing Address - State:NJ
Mailing Address - Zip Code:08318
Mailing Address - Country:US
Mailing Address - Phone:856-358-3845
Mailing Address - Fax:
Practice Address - Street 1:30 BROAD ST
Practice Address - Street 2:
Practice Address - City:ELMER
Practice Address - State:NJ
Practice Address - Zip Code:08318-2200
Practice Address - Country:US
Practice Address - Phone:856-358-3845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJE1711009341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance