Provider Demographics
NPI:1134494925
Name:LONG VALLEY FIRST AID SQUAD
Entity Type:Organization
Organization Name:LONG VALLEY FIRST AID SQUAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:KANEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-876-4567
Mailing Address - Street 1:PO BOX 111
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-0111
Mailing Address - Country:US
Mailing Address - Phone:908-876-4567
Mailing Address - Fax:908-876-1567
Practice Address - Street 1:70 EAST MILL RD
Practice Address - Street 2:
Practice Address - City:LONG VALLEY
Practice Address - State:NJ
Practice Address - Zip Code:07853
Practice Address - Country:US
Practice Address - Phone:908-876-4567
Practice Address - Fax:908-876-1567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance