Provider Demographics
NPI:1093127052
Name:LAUREL LAKE VOLUNTEER FIRE AND RESCUE CO., INC.
Entity Type:Organization
Organization Name:LAUREL LAKE VOLUNTEER FIRE AND RESCUE CO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAPTAIN
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:D'AMBROSIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:856-825-6767
Mailing Address - Street 1:PO BOX 349
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-0349
Mailing Address - Country:US
Mailing Address - Phone:856-825-6767
Mailing Address - Fax:856-765-3450
Practice Address - Street 1:5436 BATTLE LN
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-6159
Practice Address - Country:US
Practice Address - Phone:609-463-8075
Practice Address - Fax:856-765-3450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNOT YET ISSUED3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport