Provider Demographics
NPI:1144228461
Name:VIRGO MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:VIRGO MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HASSAN
Authorized Official - Suffix:
Authorized Official - Credentials:EMT
Authorized Official - Phone:973-676-7000
Mailing Address - Street 1:PO BOX 1067
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07019-1067
Mailing Address - Country:US
Mailing Address - Phone:973-676-7000
Mailing Address - Fax:973-676-7002
Practice Address - Street 1:290 SANFORD ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-1020
Practice Address - Country:US
Practice Address - Phone:973-676-7000
Practice Address - Fax:973-676-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1147015341600000X, 343900000X, 3416L0300X, 343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered341600000XTransportation ServicesAmbulance
Not Answered343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Not Answered3416L0300XTransportation ServicesAmbulanceLand Transport
Not Answered343800000XTransportation ServicesSecured Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
29937OtherUNIVERSITY HEALTH PLAN
7113152OtherAETNA INSURANCE
01000332500OtherAMERICHOICE
88348OtherAMERIGROUP
NJ1088266OtherNJ HORIZON HEALTH
1K7846OtherHEALTHNET
NJ7663301Medicaid
NJ7663301Medicaid
061896Medicare ID - Type Unspecified