Provider Demographics
NPI:1114058773
Name:TOWNSHIP OF DEPTFORD
Entity Type:Organization
Organization Name:TOWNSHIP OF DEPTFORD
Other - Org Name:DEPTFORD TOWNSHIP EMS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:E
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-686-2234
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 1:1011 COOPER ST
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-3076
Practice Address - Country:US
Practice Address - Phone:856-686-2234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDEPT00156341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ90001006001OtherAMERICHOICE
NJ0461430000OtherAMERIHEALTH
NJ7237707Medicaid
NJ96574OtherAMERIGROUP
NJ590011265OtherRAILROAD MEDICARE
NJ0461430000OtherKEYSTONE
NJ23953OtherHEALTH PARTNERS
NJ34708OtherUNIVERSITY HEALTH PLAN
NJ0860236OtherAETNA
NJ96574OtherAMERIGROUP