Provider Demographics
NPI:1083820435
Name:BOROUGH OF COLLINGSWOOD
Entity Type:Organization
Organization Name:BOROUGH OF COLLINGSWOOD
Other - Org Name:COLLINGSWOOD FIRE DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-854-1043
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:
Practice Address - Street 1:20 W COLLINGS AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-3729
Practice Address - Country:US
Practice Address - Phone:856-854-1043
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCOLL001373416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7436301Medicaid
NJ0668504000OtherAMERIHEALTH
NJ0993408OtherAETNA
NJ1065291OtherHORIZON MERCY
NJ90000571900OtherAMERICHOICE
NJ7436301Medicaid